- 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
- 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 (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
- CVS Health (Plainfield, 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 (Plainfield, 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 (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 (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
- 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
- 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
- Atlantic Health System (Basking Ridge, 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
- 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
- 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
- RWJBarnabas Health (New Brunswick, NJ)
- …related to patient evaluation, care, and management , including supervision of RN - nurse coordinators. Your efforts will ensure continuity of care, ... Heart Association (AHA) required + Must be a licensed Registered Nurse in the state of New...Supervise and develop a team of clinical staff, including RN - nurse coordinators, nurse … more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …certifications like Diabetes educator, Pediatric Nursing, Gerontological Nursing. * Current licensed Registered Nurse ( RN ) with state licensure; bachelor's ... About The Role Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases...services to its clients. Cases are maintained by the Nurse Case manager. The Nurse … more
- FlexStaff (New York, NY)
- …contact hours of mandatory training requirements such as infection control coursework. - Case Management Certification recommended within two (2) years of the ... care. Serve the organization as a member of the management team, working alongside with all departments and employees...license and registration in New York State as a Registered Nurse required. Additional Requirements: - Be… more