- Hackensack Meridian Health (Brick, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Care Management , Care Coordinator , Utilization Management ** is a member ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to… more
- Humana (Trenton, NJ)
- …health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs ... Description **Achieve your best at Humana. Join Us!** The UM Administration Coordinator provides non-clinical support for the policies and procedures ensuring best… more
- Hackensack Meridian Health (Brick, NJ)
- …advancing our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator , Care Management ** is a member of the ... expert computer skills. + Familiar with hospital resources, community resources, and utilization management . + Excellent written and verbal communication skills.… more
- Highmark Health (Trenton, NJ)
- …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... of pre-certification requests for authorization of medically necessary health care services, at the appropriate level of care...and management . + Route Cases Based on Established Guidelines. +… more
- Elevance Health (Middletown, NJ)
- …member and the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current ... **LTSS Service Coordinator - Clinician** **Location:** The location for this...law and contract, the Clinician contributes to the LTSS care coordination process by performing activities within the scope… more
- Penn Medicine (Plainsboro, NJ)
- … management of the following areas: Unit Budget Quality Improvement Plan Resource Utilization Human Resource Management Master Unit Staffing Plan Unit Risk ... monitoring in the following areas: Unit Budget Quality Improvement Plan Resource Utilization Human Resource Management Master Unit Staffing Plan Unit Risk… more
- CVS Health (Trenton, NJ)
- … and Utilization Management . AHH delivers flexible medical management services that support cost-effective quality care for members. **Key ... and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards… more
- Virtua Health (Mount Holly, NJ)
- …the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing ... care , or something in-between - we are your partner...local regulatory guidelines. Job Responsibilities: Financial / Revenue Cycle Management Oversees the daily/monthly expenditures, staffing and overtime hours.… more