- Daiichi Sankyo, Inc. (Bernards, NJ)
- … - State Licensure and/or Compact State Licensure The ideal candidate will be a Registered Nurse with previous relevant clinical as well as pharmaceutical ... of nurses working under the general direction of the Regional Director of Clinical Nurse Managers. The OCE is responsible for educating HCPs/clinics with… more
- Cognizant (Trenton, NJ)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Trenton, NJ)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Trenton, NJ)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team.… more
- US Tech Solutions (Hopewell, NJ)
- …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... care management as assigned by management.** **Responsibilities:** 1. Assesses patient's clinical need against established guidelines and/or standards to ensure that… more
- CVS Health (Trenton, NJ)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Fresenius Medical Center (Somerset, NJ)
- **PURPOSE AND SCOPE:** The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) ... from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. + Performs ongoing, systematic collection and analysis of patient data… more
- CVS Health (Trenton, NJ)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Hackensack Meridian Health (Edison, NJ)
- … utilization management. **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP ... and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for… more
- Evolent (Trenton, NJ)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- Penn Medicine (Plainsboro, NJ)
- …our future each day. Are you living your life's work? Summary: + A professional Registered Nurse who is responsible for the direct supervision of nursing staff ... clinical support Staff rooms as needed Provide resource utilization Provide educational in services related to service line...Nurse Manager follows the standards of the PACU Registered Nurse (Job Code 5028) within the… more
- Sharecare (Trenton, NJ)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Hackensack Meridian Health (Edison, NJ)
- …systems; Google Docs, EPIC. **Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP ... program and its Quality Metrics. + Knowledge of health care delivery system, utilization and review and case review procedures. + Knowledge of Social Determinants of… more
- Centene Corporation (Trenton, NJ)
- …required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required or + LCSW- ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- RWJBarnabas Health (New Brunswick, NJ)
- …years of progressive management experience in related field preferred Certifications Licenses Registered Nurse RN with valid New Jersey state license required ... to the department Director, Works collaboratively with the medical staff, clinical staff, other departmental managers, and ancillary departments, Section 2 Job… more
- RWJBarnabas Health (New Brunswick, NJ)
- …procedures, sepsis, dialysis, heart failure, and respiratory failure, The AD is a registered professional nurse who under the direction of the Nursing Director ... 7p-730am, 3 shifts per week in staffing as Charge Nurse with 8hr office day per pay period, Head...and procedures of the nursing department, Promoting effective resource utilization related to clinical practice, Using effective… more
- AristaCare (Edison, NJ)
- …process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered Nurse licensure. The Unit ... Manager - RN coordinates resource utilization , timely and appropriate care interventions, and interdisciplinary communication...and regulatory compliance. Requirements + Must possess, a valid Registered Nurse license in the state of… more
- AristaCare (South Plainfield, NJ)
- …process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered Nurse licensure. The Unit ... Manager - RN coordinates resource utilization , timely and appropriate care interventions, and interdisciplinary communication...and regulatory compliance. Requirements; + Must possess, a valid Registered Nurse license in the state of… more
- AristaCare (Plainfield, NJ)
- …process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered Nurse licensure. The Unit ... Manager - RN coordinates resource utilization , timely and appropriate care interventions, and interdisciplinary communication...and regulatory compliance. Requirements + Must possess, a valid Registered Nurse license in the state of… more
- Hackensack Meridian Health (Edison, NJ)
- …Microsoft Office and/or Google Suite platforms. **Lice** **nses and Certifications Required:** + Registered Nurse (RN) with current New Jersey (NJ) License, or ... The role of **Supervisor, Care Management** integrates and coordinates utilization management, care coordination, discharge planning functions and performance… more
