Utilization review nurse jobs in Clifton, New JerseyCreate job alerts

The Per Diem Advanced Practice Nurse (APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care model, demonstrating competencies in leadership, direct clinical practice, consultation/collaboration, coaching/guiding, research, and ethical

The Utilization Management Registered Nurse (UM RN) is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services in accordance with established criteria, regulatory requirements, and organizational role. Preferred 3+ years of Utilization Review or Case

Utilization Management RN (Registered Nurse). Like to be accountable to monitor and maintain inventory in the Utilization Management queue to meet productivity standards. Knowledge of Utilization Review Accreditation Commission (URAC).

Job Description POSITION SUMMARY: Conducts on-site initial and ongoing client assessments to identify needs and plan for services; monitors the care plan implementation to ensure achievement of desired outcomes; evaluates the performance and skills of the care providers to ensure appropriateness and compliance with standards; participates in orientation and education programs; and assumes clinical management responsibilities to ensure services provided are consistent with the mission of the organization. This can be a Full time or Part time (flexible for the right candidate). This would be a great opportunity for a candidate looking for flexible schedule and a work life balance. MINIMUM QUALIFICATIONS: 1. Exemplifies characteristics of The CareTen Promise: trust, empathy, and nurture., 2. Holds a current NJ license in good standing as a Registered nurse. BSN preferred., 3. Have a minimum of two (2) years recent, verifiable, related clinical experience as a RN, including at least one (1) year preferably in home care., 4. Demonstrated track record of strong interpersonal skills., 5. Competence in basic PC skills required to perform job functions., 6. Completed criminal background check and federal/state exclusion checks., 7. Completed Continuing Education Requirements (CEUs) as required by regulation. PRIMARY RESPONSIBILITIES: 1. Demonstrate and communicate the core values of CareTen, Inc., 2. Be available at all times during operating hours and flexible schedule after hours and weekends., 3. Demonstrates high flexibility in working with service office team., 4. Maintain high client satisfaction scores, 5. Demonstrates expertise in conflict management skills., 6. Completes comprehensive patient assessments to evaluate needs and determine eligibility for the requested home care services., 7. Develops individualized care plans and orients the assigned field employee., 8. Conducts supervisory visits to ensure needs are being met in accordance with client expectations and standard requirements., 9. Documents supervisory visits in accordance with company policies and federal and state regulations., 10. Conducts reassessments and adjusts the client’s care plan in accordance with needs identified in assessment data., 11. Assures timely completion of all required documentation., 12. Instructs family caregivers responsible for assisting with client’s personal care., 13. Monitors compliance with environmental safety and instructs clients and caregivers on preventive measures., 14. Monitors compliance with standard precautions and provides instruction as needed during supervisory visits., 15. Performs assessments of paraprofessional performance and competency as required by regulations and policies., 16. Works cooperatively with office staff, caregivers, clients and their families to ensure understanding of responsibilities for care plan implementation., 17. Communicates with physicians, authorized case managers, other care providers as required by payor sources and or indicated by client condition., 18. Participates in Performance Improvement Program activities to include a review of outcomes of care and record reviews for compliance with standards and utilization of services., 19. Assumes “on-call” responsibility during assigned service hours and on a scheduled “as needed” basis after hours OTHER RESPONSIBILTIES: 1. Demonstrates a team attitude and approach., 2. Communicates effectively with personnel in service offices., 3. Coordinates DME, supplies, and any in-services needed to during the client transition to the home., 4. Arriving on time and staying late when necessary., 5. Dressing in accordance with the CareTen Handbook.

Job DescriptionBenefits: • 401(k) matching, • Competitive salary, • Flexible schedule, • Paid time off, • Training & development, • 401(k) POSITION SUMMARY: Leads field staff in delivering exceptional client service, clinical care, quality, and adherence to policies and procedures. Accountable for internal case management and field staff evaluation and development. Conducts on-site initial and ongoing client assessments to identify needs and plan for services; monitors the care plan implementation to ensure achievement of desired outcomes; evaluates the performance and skills of the care providers to ensure appropriateness and compliance with standards; participates in orientation and education programs; and assumes clinical management responsibilities to ensure services provided are consistent with the mission of the organization. PRIMARY RESPONSIBILITIES: 1. Demonstrate and communicate the core values of CareTen, Inc., 2. Demonstrates high flexibility in working with service office team., 3. Maintain high client satisfaction scores., 4. Demonstrates expertise in conflict management skills., 5. Conduct client assessments and complete the care planning process including development, implementation, and updates to the clients individualized plan of care., 6. Responsible for clinical and client case management, 7. Provide clinical oversight to field staff, Certified Home Health Aides and LPNs., 9. Assists in agency evaluation activities., 10. Participates in state and national organizations, meetings. Seminars, workshops, and activities relating to the health professions and health care services, when appropriate., 11. Serves on and periodically reviews policies relevant to patient care with the Professional Advisory Committee., 12. Oversees all CQI and utilization review activities., 13. Oversees the implementation and evaluation of client care services inclusive of regulatory licensure and certification criteria and accreditation standards., 14. Be available at all times during operating hours and flexible schedule after hours and weekends., 15. Successfully oversee and manage all service and employment related content made to the office after normal business hours as necessary.

Coordinate Charge Nurse duties with Staff RNs acting in the relief charge capacity. Complete Nurse's Technical Training Program/Water Quality Facility Training. RN charge nurses assuming responsibility for nursing and patient servicesin the absence of the Clinical Managermust have one-yearclinical e

New Jersey regulatory agencies, including Waterfront Development, Coastal Zone Management, Coastal Area Facility Review Act (CAFRA), Natural Heritage Program (NHP), freshwater and coastal wetlands, watershed and land management (Land Resource Protection), stormwater management, New Jersey Pinelands

Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding.

Preschool Before & After Care (CELA) Coordinator .Director of Early Childhood Education .Boys & Girls Club of Clifton, CELA Speer, CELA Allwood, CELA Brighton .About the Boys & Girls Club of Clifton:.The Boys Club of Clifton, formed in 1947, and the Girls Club of Clifton, formed in 1965, came t

The professional registered nurse Home Therapies RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. Performs all essential functions under the direction of the Supervis

Assist in DOB and DOH code review, building analysis, and lease review. Final red-line review of construction documents for DOB, DOH filing and GC bid. Overall review of consultant documents.

The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator Preceptor or in collaboration with other Registered Nur

Job Title: Salesforce Project Manager.Location: NY/NJ (Hybrid – 3 days/week).Seeking a Senior Project Manager to lead Salesforce B2B delivery projects, managing end-to-end execution, stakeholders, and cross-functional teams.Manage multiple Salesforce projects (scope, timeline, budget).Drive projec

Our mission is to help nurses thrive and advance their careers by providing exceptional job opportunities, day-one benefits, and 24/7 support. The Travel Registered Nurse (RN) provides high-quality patient care across a variety of healthcare settings and specialties. Registered Nurses may work acros

Every day, our team members do amazing things in pursuit of our shared purpose to build trust with our clients, partners, subcontractors, and teammates.No matter your background, education, or career path, if you share our vision to create extraordinary experiences, you belong at HITT.Commercial Con

Registered Nurse (RN) Case Manager – Field & Telephonic Position Travel Requirement: Candidates must live in one of the following counties to be considered (Sussex, Warren, Bergen, Essex, Passaic, Hudson, etc. Key Responsibilities Conduct comprehensive assessments of members’ eligibility and hea

Coordinate and direct the activities of vendors and contractors; review vendor deliverables and performance.

Maintain accurate documentation of clinical, functional, and financial outcomes Identify opportunities for health promotion and illness prevention Proactively prevent adverse events and intervene when necessary Participate in weekly case conference meetings (Wednesdays at 8:45 AM) Required Skills &

Luxottica Group - [Nursing Assistant / Health Aide] As a Patient Care Coordinator at Luxottica, you'll: Greet patients without delay; Promptly answer the telephone in a friendly and courteous manner; Keep patient appointments on schedule by notifying doctor/provider of patients arrival, etc; Facilit

Licensure: Current, unrestricted state Registered Nurse (RN) license.

Highly competitive salaries & annual performance and compensation reviews.

Project Executive or Area Manager.The Project Manager is responsible for leading and overseeing assigned construction projects from initiation through completion.This role ensures adherence to safety standards, contractual obligations, design requirements, budget limitations, and project timelines.T

Come join one of the top construction firms in the NYC region as a Sr.This Jobot Job is hosted by: Paul Madden.Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume.Salary: $200,000 - $250,000 per year.Seeking a Senior Project Manager with strong ground-up

Monitor vendor performance and review/process vendor invoices. Monitor vendor performance, and review/process vendor invoices.

Assign nurses to shifts based on availability, skillset, and client needs.

Position Title: Technical Project Manager.Location: Manhattan, NY (Hybrid – 2–3 days onsite per week).Position Status: Long-Term Contract.We are seeking an experienced Technical Project Manager to lead the successful delivery of complex, high-impact technology initiatives in a fast-paced, collab

Primary Responsibilities Include the Following:.Manage a portfolio of multiple innovations across Personal Care Categories that will accelerate the growth of the Suave business.Develop project timelines and identify milestones that support the planned in-store date.Oversee the product development jo

Bond Vet is on a mission to strengthen the human-animal bond through better pet care.We offer primary and urgent care, so we're there for pets when they need us most.Our clinics are designed with pets and people in mind: warm, friendly, and highly sniffable.We balance this design with a strong focus

Financial Services Experience**.Expertise with a product firm OR Financial services firm.Expertise in client facing environment.Expertise managing cloud applications.Expertise in AML / Financial Crimes / Fraud etc.Minimum of 5 years, hands-on, technology experience – A MUST.Minimum of 2 ye

Job title: Project Manager (we are hiring two PMs - a mid and a senior level).Compensation: 140-170K base + 20% bonus.We are currently working on multiple large tunnel projects in Manhattan, NY, and are looking for Project Managers to join our team.We will have work in the area for years to come and

Review materials and identify long-lead items early in the project lifecycle. Assist with preparation and review of shop drawings and fabrication details.

Leading food manufacturer seeking QA Manager - Excellent benefits + room for growth & advancement!.This Jobot Job is hosted by: Gabriel Ozuna.Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume.Salary: $70,000 - $70,000 per year.For 90 years we have

Job Title: Smart Building IoT Project Manager.Required Skills & Qualifications.Project Management experience designing and deploying IoT systems for commercial high-rise buildings, with direct exposure to multi-floor (10+ story) retrofits.Project Management experience with interacting with const

Develop the Project Communication Plan, lead periodic Management Level Project Reviews, Report Project Progress.

We are seeking a Project Manager to support the R&D Manager in managing stage-controlled new product launch phases and overseeing various R&D projects both internally and with external departments.This role will be responsible for coordinating project activities, tracking progress, managing

This Jobot Job is hosted by: Kevin Shilney.Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume.Salary: $60,000 - $80,000 per year.We are a respected law firm focused on probate, estate planning, business transactions, and civil/commercial litigation.Our

Coordinate and direct the activities of vendors and contractors; review vendor deliverables, monitor vendor performance, and process vendor invoices. Review vendor deliverables, monitor vendor performance, and process invoices.

Construction Project Manager — Interiors & Office Buildouts (Manhattan).We are seeking an up and coming PM ready to lead commercial interior and office buildout projects in Manhattan from concept through completion.The ideal candidate will have a strong background in coordinating multifaceted

Maintain and review punch list process to ensure all are addressed and executed in a timely manner;.

Prepare status updates, summaries, and recommendations for executive review.