- Elevance Health (Bridgeton, NJ)
- 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
- Hackensack Meridian Health (Hackensack, NJ)
- …and regulatory/payer requirements. The role integrates and coordinates utilization management , care coordination, and discharge planning functions. RN ... with Nursing. **Education, Knowledge, Skills and Abilities Required:** + Case Manager, Registered Nurse Graduate...PC skills. + Current working knowledge of discharge planning, utilization management , case management… 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
- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse ( RN ), Case Management (per diem)Req #:0000191479 Category:Nursing Status:Per Diem Shift:Day Facility:Cooperman ... Job Title: Case Manager Registered Nurse ( RN ), Case Management...hospital setting + Minimum of one year experience in Case Management / Utilization Management … more
- Healthfirst (NJ)
- … including preauthorization of outpatient or inpatient services + Knowledge of utilization management /quality management case philosophies and ... **Duties/Responsibilities:** + Oversees utilization management functions which include timely...**Minimum Qualifications:** + Associates degree + New York State Registered Nurse + Work experience demonstrating verbal… more
- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health ... compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals,… more
- RWJBarnabas Health (Rahway, NJ)
- Per Diem Case Manager Registered Nurse ( RN ), Case ManagementReq #:0000183145 Category:Nursing Status:Per Diem Shift:Day Facility:RWJ Rahway ... hospital setting + Minimum of one year experience in Case Management / Utilization Management ...all Orientation Programs Certifications and Licenses Required: + Current Registered Nurse License in the state of… 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 (Trenton, NJ)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Trenton, NJ)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (North Bergen, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management ,… 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 (Union, 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 (Ocean City, 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. + Home… more
- CVS Health (Toms River, 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
- Atlantic Health System (Morristown, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time GIP 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
- Veterans Affairs, Veterans Health Administration (East Orange, NJ)
- Summary The Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined approach to receiving, triaging, and directing ... of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community...level degree in Nursing may have opportunity to become registered as a nurse with a state… 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
- Select Medical (Atlantic City, NJ)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... documentation. You will report directly to the Director of Case Management and provide social work services,...**Current licensure in a clinical discipline either as a Nurse ( RN /LPN/ LVN)or a Respiratory Therapist… 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