- 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)
- …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
- 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
- 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
- Penn Medicine (Philadelphia, PA)
- …day. Are you living your life's work? Summary: + The role of the Integrated Clinical Nurse Manager is an integrated role within the Oncology service line/Cancer ... Service Line (CSL). The Integrated Clinical Nurse Manager is...staff with day-to-day operations regarding patient care. Credentials: + Registered Nurse - PA (Required) Education or… 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
- 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
- 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. ... this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today...candidate for this position must be a seasoned med/surg nurse with a minimum of 5 years' experience in… 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
- ChenMed (Philadelphia, PA)
- …bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse (RN) license in State of employment required + Compact License ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...Supports, collaborates and partners with the Complex Care and Clinical Strategy Teams on the day-to-day execution of our… more
- Magellan Health Services (Newtown, PA)
- …Care MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care MgmtCare Mgmt License ... supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of...of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided… more
- Trinity Health (Philadelphia, PA)
- **Employment Type:** Part time **Shift:** **Description:** ** Registered Nurse ** **Location: LIFE Broad Street, Philadelphia PA** **Status:** On-Call **Shift:** ... holidays **$2,500 sign on bonus and day one benefits** **Position Purpose:** The Registered Nurse (RN) is responsible for providing oversight and management to… more
- Virtua Health (Pennsauken, NJ)
- …and/or certification from the State of New Jersey as a MSW or Registered Nurse .Case Management Certification (requirement within one year of hire beginning ... effectively to meet patient needs, monitors the length of stay and promotes efficient utilization of resources.* Acts as a clinical expert and maintains ongoing… more