Utilization review jobs in Camden, NJCreate job alerts

Job Description Position Summary: The SUD Assessment Coordinator is responsible for reviewing submissions for treatment as required by State and County guidelines as well as clinical parameters, including risk assessment. The SUD Assessment Coordinator must utilize clinical knowledge of best pra...

Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Philadelphia, Pennsylvania. As a registered nurse (RN), you will provide care for patients dealing with illness or injury. Posted job title: Registered Nurse / Utilization Review/Quality Assurance.

Job Description BAYADA Home Health Care has an immediate opening for a Full-Time Clinical Educator in our Philadelphia, PA Pediatric and Adult Nursing Home Care Office. If you are looking for an exciting career opportunity in a growing industry, a Clinical Educator could be the position for you! ...

Job DescriptionDescription: ***Effective October 15, 2021, all employees/contractors/interns/volunteers are required to provide our office with proof of COVID vaccination.*** COMHAR's Intensive Behavioral Health Services (IBHS) is located in the Philadelphia are. IBHS support children, youth,...

Job Description POSITION SUMMARY: The Clinical Outpatient Supervisor provides clinical and administrative oversight of the Outpatient Services at the Greenridge Counseling Center. The Supervisor role ensures that outpatient mental health treatment is delivered within a best practice framework th...

Job Description The Clinical Care Manager (CCM) Specialist- Children’s Complex Care (High-Fidelity Wraparound) is part of a specialized team, responsible for providing high intensity care management, that works collaboratively and directly with members and providers to ensure effective, holistic,...

Job Description The Community Health Worker plays a crucial role in supporting individuals facing mental health, addiction, and physical health challenges. This position focuses on leveraging personal experiences to foster hope and resilience in members, guiding them towards recovery and self-suf...

Job Description BAYADA Home Health Care has an immediate opening for a Clinical Educator in our Philadelphia, PA Pediatric and Adult Nursing Home Care Office. If you are looking for an exciting career opportunity in a growing industry, a Clinical Educator could be the position for you! Do you wa...

Job Description Counselor M-F 4:45am-1:15pm and possible Saturdays 4:45a-12p Pinnacle’s Voice: A Tale of Transformation & Recovery “I found myself like a lot of people in a position I never thought I would be in. I needed help bad… It all started with a call… one of the easiest and hardest thi...

Job Description We offer the following excellent benefits including: Loan forgiveness, Free parking, Medical, Vision, Prescription, Paid Time Off, Paid Parental Leave, Retirement Plan, Tuition Reimbursement, Dental, Life and Disability, Flexible Spending Accounts, Referral program, Employee As...

We are seeking a self-motivated and ambitious Operations Associate Manager to join our Tax team. This individual is responsible for processing client tax returns, managing tax return workflows, performing admin support for clients, onboarding new clients and team members, supporting ad-hoc delive...

Job Description Position Summary: The Clinical Service Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Service Manager must utilize ...

MedHQ Staffing Solutions is seeking a travel nurse RN Case Management for a travel nursing job in Philadelphia, Pennsylvania. Experience required: Hospital Case Management…. Acute Hospital Long Term Acute Care/Rehab/Skilled Nursing Case Management/Utilization Review Admission Criteria Care coordi...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge ...

Registered Nurse – Utilization Review (Acute Care Experience Required) Location: Fully remote (PA RN License Required) Schedule: Monday – Friday, 8:45 AM – 5:00 PM; required to work every 4th Saturday Position Overview: We are seeking a skilled and detail-oriented Registered Nurse (RN) wit...

Job Description Position Title: Outpatient Therapist (PCIT Clinician) Reports to: Clinical Supervisor Department: Administration Adoption Behavior Health HBDS IPS PEP Face Forward Foster Care Residential TPII Program: FLSA Status: Exempt Non-exempt Fee-for-Service Locati...

Job Description About Us Unique Industries is a family-owned business with over 60 years of industry experience. When you work for Unique, you get all the perks of larger corporations, such as 401K, multiple choices of healthcare plans, generous paid time off, and more. However, the difference b...

Job DescriptionCompany Description The Vertex Companies, LLC (VERTEX) is a global $150M professional services firm that offers integrated forensic consulting, expert witness services, construction project advisory, and compliance and regulatory consulting to a myriad of markets and industries. ...

Job Description The Clinical Care Manager Specialist-Children’s Complex Care is part of a specialized team responsible for providing intermediate care management by working collaboratively with members and providers across all children’s levels of care, to ensure effective, and holistic member-ce...

Job Description The Clinical Care Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Care Manager must utilize clinical knowledge of b...

Job Description The Clinical Care Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Care Manager must utilize clinical knowledge of bes...

Job DescriptionCompany Description The Vertex Companies, LLC (VERTEX) is a global $150M professional services firm that offers integrated forensic consulting, expert witness services, construction project advisory, and compliance and regulatory consulting to a myriad of markets and industries. ...

Job DescriptionThe IBHS Clinical Care Manager – Neurodevelopmental Services (CCM-ND) is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Care Man...

Job Description The Clinical Care Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Care Manager must utilize clinical knowledge of bes...

Job Description The Clinical Care Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Care Manager must utilize clinical knowledge of b...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge...

Requirements: 2-3 years Previous Case Management experience in an Inpatient/Acute Care Hospital Setting - Required Experience with InterQual and Millman Experience with discharge planning - Required Experience with all patient populations – Required Case Management or Utilization Review Certifica...

Job Description Founded in 1970 as South Philadelphia Health Action and subsequently incorporated as Greater Philadelphia Health Action, GPHA is a non-profit healthcare organization with a commitment to provide compassionate and affordable healthcare services regardless of an individual’s ability...

Job Description Job Title: Medical Director - Workers Compensation Job Summary The Medical Director serves a clinical leadership role across all COMPANY (& subsidiaries) and is responsible for medical oversight of the physical medicine network and utilization review, telephonic triage, first no...

Job DescriptionSalary: DOE About Visions Visions Management began in 2007 with the goal of reimagining the experience of move management, space planning and FF&E services for our clients. To meet this goal, we built a diverse team of experts from varied backgrounds. Visons is a Certified Women ...

Job DescriptionWe are a dynamic and growing CPA firm located in Maple Shade, NJ, providing tax, accounting, and advisory services to a diverse client base of small to mid-sized businesses and individuals. With a strong focus on client service and professional excellence, we are seeking a seasoned...

Job DescriptionCompany Description IntegriChain is the data and application backbone for market access departments of Life Sciences manufacturers. We deliver the data, the applications, and the business process infrastructure for patient access and therapy commercialization. More than 250 manuf...

Job Description Automotive Controller Position Large South Jersey Auto Dealer has an opportunity for the right candidate. Responsibilities include the following in a multi-rooftop environment: · Manage the financial close process, ensuring compliance with established timelines, including weekl...

Job DescriptionJordan And Associates Consulting is actively matching amazing treatment centers in the addiction/mental health recovery industry and candidates together. We’re opening doors to promising roles and career paths for candidates in many geographical markets across the United States wit...

Formulary Strategy & Utilization Review Pharmacist.

Monitor press production throughout each shift and area to ensure members have the necessary support and tools available for a successful shift. Review huddleboard and press status with previous shift supervisor and discuss any issues/downtime. Responsible for the utilization and balancing of all...

Previous Case Management experience in an Inpatient/Acute Care Hospital Setting - Required. Case Management or Utilization Review Certification - Highly Preferred.

American Traveler is seeking a Case Manager RN with at least two years of hospital case management experience, a BSN, and BLS certification. Expected caseload is approximately 25 cases per day,. Work in a hospital setting on the Case Management unit,.

Job Posting: Registered Nurse - Case Manager (Day Shift). Minimum 3 years in hospital case management. Case management/utilization review.

Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally. Works under the direction of the Manager of Case Management and Case Manager RN to provide assistance with the utilization review process, including communicat...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge ...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge ...

Job Description Advance your career to a whole new level providing much-needed healthcare services to underserved communities as a Psychiatric Mental Health Nurse Practitioner (PMHNP) with MediTelecare, the nation's largest telehealth company! We provide in-person, telehealth and also hybrid serv...

Job Description Prepares monthly network payments and accruals for. Applicant is also responsible for reconciling payments and accruals while also providing financial analysis, reporting, and general support for the Program Accounting Department. Preferably is able to manage time and workload in...

Job Description The Regional Director shall be responsible for the development, implementation, and quality operations of departmental services for Behavioral Health and Housing (BHH) and Intellectual and Developmental Disabilities (IDD) in the Western Pennsylvania (WEPA) region. The Regional Dir...

Job DescriptionWorld Insurance is one of the fastest-growing insurance brokerage firms in the United States offering top products and services from major providers, combined with attentive service from local agents. Founded in 2011, World now has over 2,200 employees in over 260 offices across N...

Job Description The Clinical Care Management Specialist/Integrated Care Specialist provides clinical recommendations and collaborative support to team members and physical health care staff involved in the Integrated Care Plan (ICP) Program. The Clinical Care Management Specialist reviews clinica...

Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Philadelphia, Pennsylvania. What do we do? Medical Solutions is one of the nation’s largest providers of total workforce solutions in the healthcare industry, connecting nurses and allied h...