Trabajos utilization review nurse en Jersey City, NJCrear alertas

Job Summary: • Review and evaluate the assessment and UAS information for members in the MLTC and ... nursing home admissions. • Identify opportunities to improve the quality of care by ensuring ...

Possession of a license and registration to practice nursing and 2 years of post-licensure nursing experience, one of which must have included utilization review and/or discharge planning OR ...

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift and mid shift Job ...

... review, utilization management, or case management. Technical Proficiency: • Knowledge of medical terminology is required. • Familiarity with SharePoint is highly preferred. Licensure and ...

The position requires the nurse to perform case reviews and process all requests for elective ... Knowledge of Utilization management processes is required. * Prior managed care experience is ...

Documents learning outcomes of patient/family and revises education plan Include utilization of EHR ... Engages in self assessment and peer review; utilizes resources to meet individual learning need and ...

Registered Nurse, RN with Director level Hospice/Hospital Case Management, experience required ... Develop, implement and evaluate case management programs, including utilization review, and ...

... on proper utilization of those medical devices. * Supervise procedures for students taking ... Review and maintain accurate and current health records in accordance with local governmental ...

... to ensure optimal utilization of services. * Ensure quality standards set by the external ... Provide ongoing review of emergency equipment, biological and medications in order to maintain ...

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 ...

Discipline: RN * Start Date: 12/06/2024 * Duration: 13 weeks * 36 hours per week * Shift: 12 hours ... to utilization reviews for a health plan or a combination of hospital and health plan case ...

Assess appropriate site of care utilization and continued medical necessity reviews for prior ... Graduate of an accredited 2-4 year nursing program * Active, unrestricted license to practice ...

Experience with Care Coordination, Utilization review and discharge planning Computer literacy required 1. RN Licensed as a Registered Nurse in the State of New York required. 2. Baccalaureate degree ...

... and utilization of referral services, as part of the health care system. Assists in providing ... Reviews and analyzes trends pertinent to delivery of nursing care services and collaborates with ...

Review and interpret screening and diagnostic observations and report findings to the project ... Familiarity with database utilization, regulatory compliance and human subject's protection issues

Review and ensure effective development and execution of personalized care plans that result in ... the utilization of services and implements changes and adjustments to meet needs and goals

... services review, etc., following established MetroPlusHealth Utilization Management policies ... New York State license as Registered Nurse, License Practical Nurse, or Physical Therapist required ...

Complies with infection control practices such as hand washing, proper utilization of PPE, etc ... Reviews work que/email of abnormal findings from radiologist. * Make appointment for follow -up ...

... nursing facilities based on clinical criteria. The position also involves reviewing outcomes, coding, and utilization data to enhance participant health and reduce unnecessary utilization. Benefits

In this role, the Registered Nurse (RN) will be responsible for providing evaluation, diagnosis ... Review incoming referrals and update medical chart + medical tracking * Schedule medical ...

Nurse Resident * Discipline: RN * Duration: 13 weeks * 36 hours per week * Shift: 12 hours ... Reviews all medical records and paperwork, including annual physicals and medical visit ...

... providers and nursing staff. Required Qualifications * NY medical license as an MD or DO ... Participate in utilization and peer review programs which evaluates the quality of the medical ...

Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD): • RN must prep for the visit the morning of or afternoon before (Review of ...

Discipline: RN * Start Date: 01/06/2025 * Duration: 13 weeks * 40 hours per week * Shift: 10 hours ... Participate in quality assurance activities, reviewing and improving infusion protocols, patient ...