Utilization management jobs in Hackensack, NJCreate job alerts

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...

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...

Supports & Participates in pre-admission review, utilization management, and concurrent and retrospective review process. The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for...

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...

Evaluates patient/family transition of care planning for resource utilization, cost, quality, and promotion of self-management for chronic health maintenance. Provides culturally diverse and educationally appropriate health management education. Serves as a member of organizational and department...

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 ...

Adheres to and participates in the agency's utilization management model. License Requirements * Current RN licensure in state of practice * Current CPR certification * Current Drivers License ...

Experience Minimum five years experience in utilization review management and/or case management preferred. Minimum of 5 years experience as a registered nurse required. Special Skills Registered ...

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 ...

Experience Minimum five years experience in utilization review management and/or case management preferred. Minimum of 5 years experience as a registered nurse required. Special Skills Registered ...

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 ...

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

... Case Management preferred. -Five years minimum of clinical experience as a Registered Nurse. Leadership experience preferred. Experience with Care Coordination, Utilization review and discharge ...

... utilization across projects and updates project accounting systems as required. • Addresses ... Management Professional (PMP) [certified by the Project Management Institute (PMI) Global ...

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 ...

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 ...

... management that is limited to utilization reviews for a health plan or a combination of hospital and health plan case management § Assessments that were all conducted telephonically and did not ...

... 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 ...

The working Supervisor of Case Management is responsible for providing supervision to the Case Managers, Coordinators, and Discharge Planners. Provides oversight for the quality and resource ...

The working Supervisor of Case Management is responsible for providing supervision to the Case Managers, Coordinators, and Discharge Planners. Provides oversight for the quality and resource ...

... and management; integrated behavioral health services. * Residents and Fellows are encouraged to ... 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 ...

... utilization, and growth with Mastermind. The National Vice President, Dealer Relations will join ... Manage retention forecast and costs by adjusting spend based on business conditions and ...

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 ...