- Elevance Health (New York, NY)
- RN Utilization Management - Case Management (Medicaid Long Term Care) JR155671 **Location** : New York or New Jersey. **Virtual:** This role enables ... face-to-face onboarding and skill development as needed. The **Medical Management Nurse ** is responsible for review of...and Experiences:** + A combination of utilization review/ utilization management and Case … more
- RWJBarnabas Health (Newark, NJ)
- …settings. Additionally, candidates must have at least 3 years of recent experience in Case Management , Utilization Review, or Discharge Planning, and a ... federal guidelines and is accountable for case management outcomes as outlined in the Utilization ...+ Current and valid license to practice as a Registered Nurse or Social Worker in the… more
- Mount Sinai Health System (New York, NY)
- …assure timely and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care ... degree preferred + 5 years of Case Management and 6 years as a clinical nurse...New York State + Certification in case management is preferred Non-Bargaining Unit, BEZ - Utilization… more
- RWJBarnabas Health (Newark, NJ)
- …medical necessity criteria. + Knowledge of state and federal regulations regarding case management , including utilization review, discharge planning, ... + Current and valid license to practice as a Registered Nurse OR Licensed Social Worker in... management skills. + Knowledge of discharge planning, utilization management , case management… more
- CVS Health (Linden, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... modules, and field mentoring component. Are you a licensed registered nurse who is passionate about making...Union County New Jersey area. Key Responsibilities: Coordinates all case management activities with members to evaluate… more
- Hackensack Meridian Health (Old Bridge, NJ)
- …acute care setting. + Familiar with hospital resources, community resources, and/or resource/ utilization management . + Care coordination, case management ... leader of positive change. The role of **Supervisor, Care Management ** integrates and coordinates utilization management...Google Suite platforms. **Lice** **nses and Certifications Required:** + Registered Nurse ( RN ) with current… more
- CVS Health (Linden, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... + **MUST have own transportation.** **Preferred Qualifications** + LTSS experience + Case management and/or discharge planning experience + Managed Care… more
- CVS Health (Jersey City, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... Qualifications** + Home Health and/or Home Hospice Experience + LTSS experience + Case management and/or discharge planning experience + Managed Care experience… more
- CVS Health (Freehold, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... the State training modules, and field mentoring component **Preferred Qualifications** + Case management and/or discharge planning experience + Managed Care… more
- CVS Health (Bayonne, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... mentoring component. **Preferred Qualifications** + Candidates residing in Hudson County + Case management and/or discharge planning experience + Managed Care… more
- CVS Health (South Plainfield, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... Choice certification is a contingency of employment. **Preferred Qualifications** + Case management and/or discharge planning experience preferred. + Managed… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** RN / Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case ... or a minimum of 3-5 years? experience as a RN in an acute care setting. **Licensing and Certification...patients where utilization review, discharge planning, and/or case management will be needed using standardized… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers' ... disability services for timely return to work. + Provides case management , utilization review, continued...MagnaCare policies and procedures. Essential Qualifications + Currently licensed Registered Nurse in the state of NY,… more
- Mount Sinai Health System (New York, NY)
- …admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve ... Manager (CM) will be responsible for all aspects of case management for an assigned group of...Sinai St. Luke's and Mount Sinai West, BEZ - Utilization Management - WST, Mount Sinai West… more
- Atlantic Health System (Newark, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work Monday - Friday from 8 AM to 4 PM in the ... as necessary + Documents patient education tools used Assumes responsibility for Case Management . + Develops/implements/evaluates plan of care based on… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …headed by young adults ages 18 to 25 years old providing health care and management coordination. The Registered Nurse will: + Conduct assessment of the ... ESSENTIAL DUTIES AND RESPONSIBILITIES The Registered Nurse will serve young adults...to: + Positive Youth Development + Recovery-Oriented and Trauma-Informed Case Management + Critical Time Intervention +… more
- RWJBarnabas Health (Long Branch, NJ)
- … RN License + 3 to 5 years acute care RN experience + Case Management experience Preferred: + Utilization Review or Discharge Planning Experience + ... RWJBarnabas Health is seeking a highly dedicated RN to work per diem in Case Management for Monmouth Medical Center. Monmouth Medical Center (MMC) is one of… more
- Molina Healthcare (New York, NY)
- …authorization requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States...meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience**… more
- Northwell Health (Staten Island, NY)
- …as a Registered Professional Nurse in New York State. + Case Management Certification, preferred. + Minimum of one (1) year related experience, required. ... care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts... of patient care outcomes. + Submits data to management regarding case management and/or… more
- Hackensack Meridian Health (Holmdel, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to.... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more