- 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)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… 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
- Fresenius Medical Center (Wilmington, DE)
- **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
- 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
- CVS Health (Trenton, NJ)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… 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
- Virtua Health (Marlton, NJ)
- …services in Burlington, Camden and Gloucester counties. The ideal candidate is a Registered Nurse with a minimum of one-year medical/surgical experience. Prior ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… 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
- Lincoln Financial (Trenton, NJ)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible… more
- CVS Health (Trenton, NJ)
- …inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN, the TOC Coach ensures the member experiences a seamless ... - Management of warm transfers form concierge and engagement hub - Provides clinical assistance to determine appropriate services and supports due to member's health… more
- CVS Health (Trenton, NJ)
- …utilization to improve clinical care and outcomes. Required Qualifications: Registered Nurse (RN) required. Working knowledge of problem solving and ... of policies, procedures, and guidelines that focus on improving clinical quality and ensuring patient safety. Collaborates with cross-functional teams,… 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
- 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
- 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
- Virtua Health (Mount Holly, 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