- Universal Health Services (Westampton, NJ)
- …core of Hampton Behavioral Health Center's mission. We are looking for a Full Time Utilization Review Coordinator . In this role you will assist in screening ... patients to ensure that criteria are met, perform admission clinical reviews, facilitate discharge planning and coordinate continuum of care for the patient with the treatment team. In this position you will interact and communicate with clinical staff,… more
- Hackensack Meridian Health (Edison, NJ)
- …regulations for Nursing. **Responsibilities** 1. Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... **Overview** The Care Management, Care Coordinator , Utilization Management is a member...as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions. 4. Performs chart… more
- Penn Medicine (Plainsboro, NJ)
- …Are you living your life's work? Summary: + Specialty Team Coordinator assumes responsibility and accountability for the direction, implementation and evaluation ... specialty assigned at the direction of the Nurse Manager. The Specialty Team Coordinator ensures the delivery of patient care through the coordination of customer… more
- Hackensack Meridian Health (Perth Amboy, NJ)
- …mission to transform healthcare and serve as a leader ofpositive change. The Care Coordinator , Care Management is a member of the healthcare team and is responsible ... **Responsibilities** A day in the life of a **Care Coordinator , Care Management** at _Hackensack Meridian Health_ may include:...or meetings + Identifies and refers quality issues for review to the Quality Management Program + Participates in… more
- Hackensack Meridian Health (Edison, NJ)
- **Overview** The Care Coordinator , Care Management is a member of the healthcare team and is responsible for coordinating, communicating, and facilitating the ... workgroups, and or meetings. 8. Identifies and refers quality issues for review to the Quality Management Program. 9. Participates in multidisciplinary rounds,… more
- Highmark Health (Trenton, NJ)
- …**Job Description :** **JOB SUMMARY** This job captures all inbound requests for utilization review from providers and pharmacies. The incumbent assesses the ... and then creates the case (data entry) in Highmark's utilization management system for clinical review . Ensures all accurate information is entered at the onset… more
- GovCIO (Trenton, NJ)
- …and Information System Security Officers (ISSO) to establish efficient team utilization . **Responsibilities** + Attend work groups, meeting and other technical ... GovCIO and VA management to interpret their needs and requirements. + Review system documentation (Security Plans, Risk Assessments, Network Diagrams and SOPs) to… more
- Centene Corporation (Trenton, NJ)
- …disabilities and/or behavioral health conditions. Experience in insurance and utilization review . **License/Certification:** Valid driver's license. Social ... Worker, LPN, LVN, or RN preferred.. Pay Range: $22.36 - $38.07 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a… more
- NJM Insurance (Trenton, NJ)
- …Workers' Compensation line of business by performing prospective and retrospective Utilization Review of pharmaceutical/medication requests in accordance with ... and causally related. + Evaluate requests that are routed for clinical review based upon established criteria to issue appropriate and timely determinations on… more
- RWJBarnabas Health (Somerset, NJ)
- …needs. + Monitors and assesses the use of hospital services by administering utilization review procedures under Federal, State and hospital guidelines. + ... Participates in facilitating new hire orientation + Participates in special projects and other duties as assigned + Holiday and weekend requirement Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of… more
- Burlington (Burlington, NJ)
- …non-technical staff to resolve and drive issues. **A Day in the Life** + Review Technical drawings, create action plans, and manage and coordinator asset ... that could help improve the store's AP Technology deployment, appearance, and utilization . + Provide written and oral reports, project updates, and communication… more