Utilization review jobs in Bayonne, NJCreate job alerts

Minimum of two (2) years utilization review/case management experience or social work experience.

Minimum of two (2) years utilization review/case management experience or social work experience.

Minimum of two (2) years utilization review/case management experience or social work experience.

TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in West Orange, New Jersey, 07052!.Host Healthcare is an award-winning travel healthcare company with an immediate opening for this.Passionate and transparent team members have made Host Healthcare the agency of...

Our recruiters act not only as your dedicated travel career mentor but also become your number one advocate. License, travel, tuition, and scrub reimbursement. This means you get priority access to apply to travel and local assignments before other applicants.

Host Healthcare is an award-winning travel healthcare company with an immediate opening for this. At Host Healthcare, we are dedicated to empowering the life and healthcare career you deserve. TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in Syracuse, New Y...

TravelNurseSource is working with LRS Healthcare to find a qualified Case Manager RN in White Plains, New York, 10601!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24/7 support, and a responsive, traveler-first culture.What are you waiting for? Apply t...

You'll work closely with social workers, physicians, and other team members to ensure smooth transitions of care for patients, including referrals to skilled nursing facilities (SNFs), community resources, or home settings. Collaborate with interdisciplinary teams, including social workers and ph...

Performs all UR activities per department policy:Commercial payer reviewsDisposition determination,Retro/self-auditMC varianceAdmission clinical review.

TravelNurseSource is working with Care Team Solutions to find a qualified Case Manager RN in Syracuse, New York, 13210!. Must Have 2+ Years of recent Case Manager experience. Exposure to a variety of cases and healthcare environments improves your clinical judgment and decision-making skills.

At Fusion Medical, we truly believe that as people taking care of people, together we can do anything. One to three years experience as a Registered Nurse preferred. Provides and coordinates patient care with other health team members.

TravelNurseSource is working with Fusion Medical Staffing to find a qualified Case Manager RN in Bronx, New York, 10457!. Registered Nurse - Case Manager. Case Manager Registered Nurse travel assignment.

Client in NY seeking RN (Registered Nurse) (RN) to work DaysDays.A northeastern state just located west of New England, New York is home to some of the greatest visiting sites in the united states.From Niagara falls to the Statue of Liberty to the Empire State building or even to time square th...

Conduct Utilization review via Chart Review. * Conduct timely concurrent reviews and responses to third party payors request for clinical reviews. * Work collaboratively with ED Case Managers and ...

Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift and mid shift Job types available: full time, part time, and per diem Employer features: Cross training ...

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 ...

Actively participates in Quality Assurance/Performance Improvement and Utilization Review activities. * Conducts medical records audits, participates in needs analyses, oversees new/revised practices ...

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 ...

The Case Manager is responsible for all aspects of discharge planning and utilization management/review for an assigned group of patients to determine the appropriateness of the admission and ...

Utilization Management * Participate in utilization review and management. * Maintain focus on key strategic priorities including patient experience, access to care, increased market share, and ...

A minimum of two years experience performing utilization review, claims adjudication, medical review, fraud investigation, surveillance or monitoring activities, required; OR * Three years of ...

Assess appropriate site of care utilization and continued medical necessity reviews for prior authorization to vendors. * Ensure communication with MD offices in relation to Site of Care program

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 ...

The position also involves reviewing outcomes, coding, and utilization data to enhance participant health and reduce unnecessary utilization. Benefits * Medical, Vision, Dental, and Life Insurance