Utilization management rn jobs in Edison, New JerseyCreate job alerts

Consults and seeks guidance from the RN as necessary. At the direction of the RN, participates in Utilization Management or Interdisciplinary Care Management Meeting to facilitate appropriate discharge planning:. Contributes to an environment that is respectful, team-oriented, and responsive to the

Role Overview We’re seeking experienced Utility Management Nurses to support a client’s healthcare product development by leveraging expertise in insurance coding and hospital revenue management workflows. This role involves collaborating with hospital systems to align medical documentation with insurance policies, ensuring accurate coding and optimal reimbursement outcomes. ### Key Responsibilities - Insurance Coding & Revenue Cycle Alignment: Review, audit, and optimize insurance coding practices across hospital systems to ensure compliance and maximize reimbursement accuracy. - Workflow Analysis: Evaluate existing revenue management workflows and recommend improvements tailored to client’s AI-driven documentation tools. - Clinical Data Interpretation: Translate complex clinical notes into standardized coding formats (ICD-10, CPT, HCPCS) aligned with payer policies. - Policy Matching: Assess coding accuracy against insurance guidelines and payer documentation requirements. - Product Development Collaboration: Work closely with client’s engineering and product teams to refine AI models that automate or assist with medical coding and documentation. - Compliance & Quality Assurance: Ensure alignment with HIPAA, CMS, and payer-specific coding regulations. ### Required Qualifications - Licensure: Registered Nurse (RN) or equivalent clinical background. - Experience: Minimum 3–5 years in medical coding, clinical documentation improvement (CDI), or revenue cycle management. - Certifications: CPC, CCS, or CRC certification preferred. - Domain Expertise: Familiarity with hospital billing systems, payer policy interpretation, and coding audit procedures. - Analytical Skills: Strong understanding of clinical documentation standards and payer logic. - Tech Savvy: Comfortable working with EHR systems (Epic, Cerner, Meditech) and documentation review software. ### Preferred Qualifications - Experience working within hospital revenue integrity teams or insurance utilization management. - Exposure to AI-powered healthcare documentation tools or automated coding systems. - Ability to identify and flag edge cases or policy exceptions in automated workflows. - Strong collaboration skills with cross-functional (engineering, compliance, and data) teams. ### Engagement Model - Contract / Part-time (Remote/In person) — Flexible hours with collaboration during U.S. business hours. In person in San Francisco is a plus

As a Unit Manager/Director - RN where within an assigned unit you will support the Director of Nursing with the delivery of high quality care while achieving positive clinical outcomes, and patient/resident, family and employee satisfaction.

Manages staff typically composed of RNs, administrative and technical staff (staff may be exempt or nonexempt); Responsible for following appropriate processes for staff management including talent acquisition, staff development and performance management. Oversees the overall management of a medium

Entry level for RNs with less than 1 year of Nephrology Nursing experience in the last two years as a RN. Outpatient Registered Nurse- RN at Fresenius summary:. The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP).

Change the lives of our patients/residents and at the same time enjoy the rewards of fully knowing your patients/residents and their families as a Registered Nurse - RN.

Entry level for RNs with less than 1 year of Nephrology Nursing experience in the last two years as a RN. Outpatient Registered Nurse- RN at FRESENIUS summary:. The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP).

Makes decisions that demonstrate knowledge of nursing practice; utilizes sound nursing judgment in clinical and patient care management situations. Among its many honors and accreditations, CentraState is one of less than two percent of hospitals nationwide to earn Magnet® designation for nursing e

Candidates must hold a current New Jersey RN license and 1-2 years of recent CVOR experience, with shifts available at night. Supplemental Health Care is seeking a travel nurse RN CVOR for a travel nursing job in New Brunswick, New Jersey. To learn more about Share the Care, check out shccares.

Are you a dedicated and compassionate Registered Nurse (RN) seeking a rewarding career in Wayne, New Jersey? Our Client facility is a leading skilled nursing facility that values excellence in care, and we're thrilled to invite both local and Travel Nurses to be part of our dynamic team. Current RN

Travel Nurse, Telemetry RN, Nursing Jobs, Healthcare Staffing, Registered Nurse, Triage Nursing, RN Telemetry, Emergency Nursing, Nurse Assignment, Healthcare Careers. Triage Staffing is seeking a travel nurse RN Telemetry for a travel nursing job in Holmdel, New Jersey. Earned vacation bonuses for

Posted job title: RN - Telemetry. We make your travel healthcare journey easy by taking care of all the details, so you don’t have to. Travel Nurse, Telemetry RN, Registered Nurse, Nursing Jobs, Healthcare Travel, Holmdel NJ, Travel Healthcare, Host Healthcare, Nurse Staffing, Telehealth.

Travel Nurse, Telemetry Nurse, RN Jobs, Healthcare Jobs, Nursing Jobs, Travel Nursing, Medical Solutions, Patient Care, Nurse Benefits, RN Telemetry. Travel Nurse RN - Telemetry - $2,328 per week at Medical Solutions summary:. As a Travel Nurse RN specializing in Telemetry, you will provide critical

Concierge state licensing program for RN and other healthcare modalities in multiple states, including CA. Ask your recruiter to learn more!. Travel Nurse, Interventional Radiology, RN, Epic Travel Staffing, Healthcare Staffing, Travel Nursing Jobs, Nursing Jobs, Healthcare, Patient Care, Nurse Staf

Current RN licensure in state of practice.

Travel Nurse RN - CVOR - $2,851 per week at Nightingale Nurses summary:. As a Travel Nurse RN specialized in CVOR, I provide critical nursing care in surgical settings, focusing on cardiovascular operations. Nightingale Nurses is seeking a travel nurse RN CVOR for a travel nursing job in New Brunswi

With over 30 years of experience, GHR Healthcare focuses on matching healthcare professionals with facilities nationwide, ensuring competitive compensation and support throughout the career journey. GHR Healthcare - Travel Division is seeking a travel nurse RN CVOR for a travel nursing job in New B

Understand and practice the proper method of attending to and disposing of and the possibility of exposure to blood borne pathogens, bodily fluids, infectious waste, sharp sticks, and hazardous materials in compliance with universal care precautions. Ensure resident changes, concerns, and/or solutio

If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Early access to ear

Health Advocates Network was founded based on a shared aspiration to improve the way healthcare staffing is done.We are a company founded by healthcare professionals and built for healthcare professionals.As your true advocates, we will always help you thrive and pave the path forward in your career

At least 2 years of RN experience required. At least 1 year working as RN in an oncology setting administering chemotherapy. Outpatient oncology infusion RN experience strongly preferred.

Understands, conducts, and documents appropriately Dialysis/Apheresis machine safety tests/alarm tests, equipment calibration, dialysate testing, machine safety tests, functional testing, and internal and external disinfection on all water & dialysis machines, and complies with the documentation/not

Competent in organizational and time management skills. Maintains a current state/provincial license as a professional Registered Nurse (RN). Demonstrates proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) and Sunrise applications with the ability to learn new applications.

Paid Time Off (PTO) Medical and Prescription Drug Insurance Dental and Vision Insurance Retirement Plans Short & Long Term Disability Life & Accidental Death Insurance Tuition Reimbursement Health Care/Dependent Care Flexible Spending Accounts Wellness Programs Voluntary Benefits Discounts T

Our Hospice of New Jersey team is looking for a Full-Time Registered Nurse Case Manager (RNCM) that is ready to make a meaningful difference in the lives of the patients and families we serve in and around the Bloomfield Area. We are looking for a high-energy, compassionate, detail-oriented Register

Required Certifications and Licenses: Active NJ RN License or Multistate RN License with NJ Endorsement BLS certification through American Heart Association BSN Degree from an accredited School of Nursing Minimum two (2) years supervisory/leadership experience Essential Functions: The Assistant Dire

You will be required as a Registered Nurse (RN) to operate with great attention to detail and a big heart. Currently licensed Registered Nurse (RN) - New Jersey.

A-3P FULL TIME RN $5,000 SIGN ON BONUS. Responsibilities: Change the lives of our patients/residents and at the same time enjoy the rewards of fully knowing your patients/residents and their families as a Registered Nurse - RN. On-Demand Pay Program that allows for instant access to a portion of the

All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local l

Primary Specialty Primary SpecialityAudits Infection Control / RNBlood Bank TechNurse Aneshesiology / CRNACare Management / RNCardio Vascular Operating Room Tech (CV OR)Anesthesiology / MDCase Management / RNCath Lab TechCardiology / MDCath Lab / RNClinical Lab TechnologistDermatology / MDClinic / R

Refer a friend and earn extra cash !! Please call for more information 888-704-0711.

Learn why 2025 is our third year in a row being recognized as one of the "Best Places to Work in New Jersey". Current license in good standing to practice as a RN in New Jersey. The area's highest quality nursing care residence providing a warm and compassionate environment in a state-of-the-art-com

Registered Nurse (RN) - Internal Float Pool. RNs are trained in ACLS, NIH, IV Ultrasound, and cross trained to be Charge RN. Why Join Our Internal Float Pool?.

Active New Jersey RN License or approved RN license required. Supports the philosophy, objectives and the mission and vision of Saint Barnabas Medical Center and the Department of Nursing. At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and r

The Outpatient RN Pre-Admission Testing will:. Learn more about our benefits by visiting our site at Saint Peter's. Outpatient RN Pre-Admission Testing.

Active New Jersey RN License or approved RN license required. Supports the philosophy, objectives and the mission and vision of Saint Barnabas Medical Center and the Department of Nursing. At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and r

Minimum of 1 year of RN experience in an operating room required. Must maintain CNOR certification and RN licensure in good standing. Today, we continue to research, ask questions, and continuously enhance the candidate journey and client experience.

We are currently seeking experienced RN to work in our surgery center:. Organizes time, equipment, supplies, and personnel to provide effective and efficient case management. Considers cost containment by using supplies economically and in effective turnover time.

As a Float Pool RN, you will gain a wealth of experience by working in various settings including ED Boarding, Medical-Surgical, Telemetry, and ICU units. ACLS, NIHSS, IV Ultrasound training, and cross-training to Charge RN. Competitive pay, including internal float differential.

Current, valid RN license in the state of New Jersey. Minimum of 1 year of RN experience in an operating room required. Must maintain CNOR certification and RN licensure in good standing.

Identifies resident/family learning needs based on the discharge care plan as applicable and carries out appropriate teaching required. RN (Registered Nurse) Qualifications/Requirements:. RN (Registered Nurse) (All Shifts).

As aregistered nurse (RN)joining our team, you̢۪re embracing a vital mission dedicated tomaking communities healthier. Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve. Connect with our RN recrui

Our team members are the heart of what makes us better.With a culture rooted in connection and collaboration, our employees are team members.Here, competitive benefits are just the beginning.It’s also about how we support one another and how we show up for our community.Together, we keep getting b

Registered Nurse-RN-MDS Coordinator Schedule and Benefits:. That's why we're looking for an RN MDS Coordinator who's ready to lead with compassion and make a meaningful impact every day. Registered Nurse (RN) MDS Coordinator Qualifications and Responsibilities:.

As a Behavioral Health RN, also sometimes called a Mental Health RN, you will be responsible for providing nursing care for patients who have a mental illness or who may be experiencing behavioral challenges or mental distress. Trustaff is seeking a travel nurse RN Behavioral Health for a travel nur

Registered Nurse (RN) (Flexible Staffing Unit) - Nights. The RN delivers culturally sensitive, patient-centered care in accordance with ANA standards, the New Jersey Nurse Practice Act,. Make decisions that demonstrate knowledge of nursing practice; utilizes sound nursing judgment in clinical and pa

Nightingale Nurses - Allied is seeking a travel nurse RN Case Management for a travel nursing job in Morristown, New Jersey.

We provide our team with everything necessary to help you succeed and grow! Come join us as an RN and turn your work dreams into reality. Ability to Adapt and take on all responsibilities of the RN role. Benefits For an RN Registered Nurse.