Utilization management jobs in Englewood, NJCreate job alerts

About Us One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn’t your average doctor’s office. We’re on a mission to transform healthcare, which means improving the experience for everyone involved...

Monitors and intervenes on LOS, resource utilization and denial management/ prevention within the assigned caseload. Education Bachelor's degree (BSN) in nursing required. Experience Minimum 5 years ...

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. Follow up with assigned nurses for clinical updates to care plan. Document within two business day ...

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. * Follow up with assigned nurses for clinical updates to care plan. * Document within two business day ...

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. * Follow up with assigned nurses for clinical updates to care plan. * Document within two business day ...

Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift and mid shift Job ... management, preferably within a healthcare or hospital setting Exceptional interpersonal and ...

Complete Readmission screen in the Care Management Module (CarePort). * Conduct Utilization review via Chart Review. * Conduct timely concurrent reviews and responses to third party payors request ...

This CARM role will manage a team responsible supporting SPGI's acquisition, utilization, and distribution of market data sourced from stock exchanges globally. The primary focus will be to review ...

The Nurse Manager (RN) will: * In conjunction with the DON and HR Manager, recruit, hire, monitor ... Monitor utilization of nursing services and staffing productivity * Provide clinical nursing ...

Responsible for case management and patient care delivery through nursing assessment, nursing intervention, patient education, patient care coordination and utilization of referral services, as part ...

Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. * Obtains a thorough and accurate member history to ...

... management of members with chronic and/or catastrophic illness, members who are frail elderly and ... Combine utilization of medical care and pharmacy, with specific focus on the transition of care ...

Participate with materials management in the review and selection of all specialty supplies, dressings, and materials for wound and ostomy care to facilitate cost-effective utilization and compliance ...

Mentor junior staff in the utilization of security tools, report generation, and issue resolution ... Enhance visibility and detective capability in a fully managed Azure/AWS environment. * Conduct ...

Managing a patient panel with a broad array of patient needs; conducting a mix of acute, chronic ... Utilization of your specific clinical training and opportunities to perform in-office procedures ...

The NP is responsible for managing protocols for study subjects enrolled in therapeutic and non ... Familiarity with database utilization, regulatory compliance and human subject's protection issues

REGISTERED NURSE The Registered Nurse reports to the Nurse Manager. This position provides ... to ensure optimal utilization of services. * Ensure quality standards set by the external ...

... evaluation and management; integrated behavioral health services. * Residents and Fellows are ... care, to utilization of data to individually tailor our services for continual improvement in ...

Meet regularly with the Behavioral Health Manager and Chief Behavioral Health Officer. * Consult ... Participate in Utilization reviews and remaining available for emergency consultations. • Analyze ...

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works ...

Case management: 1 year (Preferred) License/Certification: * RN (Required) Work Location: On the road, field based.

Experience in case management preferred. * Certifications: * Case Management Certification (CCM or ACM) preferred or willingness to obtain. * Skills: * Strong clinical knowledge * Excellent ...

Job Overview - RN Case Manager (MLTC) Step into a key role as an RN Case Manager with our client, supporting MLTC members throughout the Bronx and Westchester, NY. This hybrid role combines remote ...

This position coordinates with Care Management Team (CMT) to maintain efficient and effective operations of Healthfirst's long term care plans such as CompleteCare and Senior Health Partners. Duties ...