Utilization management jobs in Summit, NJCreate job alerts

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...

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...

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...

This Case Management (Utilization Review) in RN (Registered Nurse) job in Bronx, NY could be the next chapter in your story of personal and professional growth.

Previous experience in utilization management required. The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 ...

The Care Manager under the direction of the Vice President of Clinical Services, is primarily responsible for managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize unnecessary medical expenses, through the coordination of services, both outpatie...

Precertification: Utilization Management Nurse Consultant - SCPU.

Assists all departments with the resolution of members’ problems related to utilization management issues. Performs all Utilization Management activities in compliance with all regulatory agency requirements. Conducts medical record reviews as appropriate to case management functions.

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...

As a new Director of Utilization Management at VillageCare, you can expect to oversee the utilization review process, collaborate with interdisciplinary teams to optimize patient care, and develop strategies to enhance operational efficiency. Would you be a great Director of Utilization Managemen...

Case Management (Utilization Review).

Precertification: Utilization Management Nurse Consultant -SCPU.

Care Management, Care Coordinator, Utilization Management. 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...

The Supervisor, Care Management is accountable for oversight of the department's designated team member caseloads and plans effectively in order to meet staffing needs, manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards a...

Rutgers, The State University of New Jersey is seeking a Utilization Management Coordinator for the Utilization Management Department within Rutgers University Behavioral Health Care. The primary purpose of the Utilization Management Coordinator is to coordinator conduct utilization reviews to en...

The Director of Case Management & Utilization will be responsible for the strategic direction setting, management, continuous improvement, and maintenance of the Case Management/Utilization. Two (2) years of experience in case management/utilization review/quality improvement leadership position ...

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...

Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and...

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).

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...

Job ResponsibilitiesProviding expert nursing care as an RN in post-acute care facilitiesKeeping track of care options and tracking outcomes with other medical staffWorking with residents and medical staff to develop care plansProperly setting up and monitoring medical equipmentEnsuring residents ...