Utilization management jobs in East Orange, NJCreate job alerts

201 Third Street (61049), United States of America, San Francisco, CaliforniaAI Engineer - Sr. Manager Level (IC)Overview: At Capital One, we are creating trustworthy and reliable AI systems, changing banking for good. For years, Capital One has been leading the industry in using machine learning...

Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements and follows th...

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. We want ev...

The Case Management Care Coordinator, Utilization Management is a member of the healthcare team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilizatio...

A traveler facility in Bronx, NY is seeking its next amazing RN (Registered Nurse) to work in Case Management (Utilization Review).

The Utilization Management Registered Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Previous experience in ut...

The Case Management Care Coordinator, Utilization Management is a member of the healthcare team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilizatio...

The Director of Utilization and Case Management will spearhead the strategic direction, management, continuous improvement, and overall maintenance of the Utilization and Case Management Services Unit. Lead the Utilization and Case Management Department at University Hospital, a prestigious healt...

Performs care management including hospital admission certification, continued stay review, discharge planning, outpatient, and ancillary services review, etc. Informs member and provider of Utilization Management determinations and treatment alternatives. Assists all departments with the resolut...

Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements and follows th...

Performs care management including hospital admission certification, continued stay review, discharge planning, outpatient, and ancillary services review, etc. Informs member and provider of Utilization Management determinations and treatment alternatives. Performs all Utilization Management acti...

Precertification: Utilization Management Nurse Consultant - SCPU.

This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropri...

Precertification: Utilization Management Nurse Consultant. Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Prior Authorization or Utilization Management experience.

Active New York State Licensed Practical Nurse (LPN) or Registered Nurse (RN) license. Utilization Management Nurse (MLTC Focus). Remote, New York (Active NY nursing license required).

Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process. Nurse Medical Management II - Utilization Management. Ensures medically appropriate, high quality, cost effective care through as...

To excel as the Director of Utilization Management at VillageCare, you must possess. Director of Utilization Management. This role will require you to lead a team of utilization management professionals, provide guidance on complex cases, and communicate effectively with stakeholders.

Case Management (Utilization Review).

South Heathwood Drive, Marco Island, FL, 34145.NCH is an independent, locally governed non-profit delivering premier comprehensive care.Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida t...

Manage and provide coaching, training, support and motivation to team members. * Monitor and ... Promote flexibility in staff utilization and delegate work appropriately across teams and ...

The Registered Nurse is an individual practitioner and the interdisciplinary team manager, utilizes the nursing process to integrate all aspects of the provision of care and individualizes the plan ...

... and utilization management that promotes positive patient outcomes (for example but not limited to, therapy utilization, client no visit, missing TIF OASIS, agent visit time, missed visit ...

Complementary multidisciplinary team + behind-the-scenes utilization management team * $300,000+ income potential * Expansive training program affiliation with Rutgers University Community ...

This partnership will provide a comprehensive clinical resource management program that includes utilization management, progression of care management, social work services, and complex discharge ...