- 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
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... 7pm EST approximately 3-4 Thursday and Friday's annually. The Utilization Management Nurse 2 uses clinical...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
- CVS Health (Trenton, NJ)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... all with heart, each and every day. Position Summary Utilization Management is a 24/7 operation and work schedules...will include weekends, holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to… 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 ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- Fresenius Medical Center (Pottstown, PA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… 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
- St. Luke's University Health Network (Sellersville, PA)
- …regardless of a patient's ability to pay for health care. This Weekend registered Nurse works collaboratively with other members of the interdisciplinary team ... standards for the provision of quality care, appropriate service utilization , and compliance with third party payor requirements for...school of professional nursing who is licensed as a Registered Nurse by the state in which… more
- ChenMed (Philadelphia, PA)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... on-call coverage, the incumbent in this role provides remote clinical advice and assessments within license and as possible...license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and… more
- St. Luke's University Health Network (Bethlehem, PA)
- …graduate of an approved school of professional nursing who is licensed as a Registered Nurse by the state in which practicing, Baccalaureate degree preferred. ... to agency standards for the provision of quality care, appropriate service utilization , and compliance with third party payor requirements for reimbursement. 7.… more
- St. Luke's University Health Network (Bethlehem, PA)
- …regardless of a patient's ability to pay for health care. This Weekend registered Nurse works collaboratively with other members of the interdisciplinary team ... to agency standards for the provision of quality care, appropriate service utilization , and compliance with third party payor requirements for reimbursement. +… more
- St. Luke's University Health Network (Easton, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the ... populations across the continuum of care. Also works with the providers, registered nurse care managers, social workers, and multi-disciplinary care teams… more
- CVS Health (Riverton, NJ)
- …hires upon achieving proficiency in the role. **Required Qualifications** + Active, unrestricted ** Registered Nurse (RN) license in New Jersey** . + Minimum of ... high-quality, cost-effective care for our members. These strategies encompass utilization management, quality improvement, network coordination, and clinical … more
- WellSpan Health (East Earl, PA)
- …or + Licensed Practical Nurse Multi State License Upon Hire Required or + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... planning and implementation of patient care based upon sound nursing judgment, clinical preparation, knowledge, skills and experience. Nursing care is provided in… 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
- Carbon Lehigh Intermediate Unit 21 (Schnecksville, PA)
- …(BSN). + Valid First Aid, CPR, and AED Certification. + Valid PA Registered Nurse License. Skills/Knowledge: + Demonstrates a proficient understanding and ... Assistant Director of Special Programs and Services under the clinical guidance from the Certified School Nurse ....utilization of Microsoft Office Suite and other software packages… more
- St. Luke's University Health Network (Bethlehem, PA)
- … nurse license in Pennsylvania and/or New Jersey as appropriate . Maintenance of clinical competence as registered nurse . Represents the School in a ... in full time recent practice. Demonstrated experience and effectiveness as a clinician. Utilization of clinical research findings in nursing practice. T raining… more
- Penn Medicine (Philadelphia, PA)
- …on needs of the unit, this individual may also serve in the capacity as a clinical nurse in the operating room. Follows fiscal and Human Resources policies in ... (Required) + BLS/CPR, as a healthcare provider as per the American Heart Association. + Registered Nurse - PA (Required) + Pennsylvania RN licensure + 2-5 years… more
- Penn Medicine (Philadelphia, PA)
- …into daily assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more