Utilization review jobs in Jersey City, NJCreate job alerts

Overview: The Project Director is responsible for, but not limited to, directing, planning and managing all requirements for Civil and Construction projects including change orders, submittals, procurement, project financial set-up, project financial updates, and project schedule to ensure projec...

Directs all aspects of the program and is responsible for: planning, continued program development, Quality Assurance, performance improvement, utilization review, customer satisfaction, and other projects assigned. Responsible to oversee daily operations of the Involuntary Outpatient Commitment ...

Do you thrive in a dynamic, fast-paced environment and enjoy the flexibility of travel nursing? If so, we have an exciting opportunity for you! We are seeking a dedicated Travel RN specializing in Utilization Review to join our team. ...

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.

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 Bronx, New York, 10457!.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 choice ...

TravelNurseSource is working with LRS Healthcare to find a qualified Case Manager RN in White Plains, New York, 10601!.

We know that you are so much more than a number and we work hard to ensure you have the best benefits for you and your loved ones. TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in West Orange, New Jersey, 07052!. When you work with us, you can trust that we...

ARMStaffing is looking for RN - Case Management in Bronx, New York.

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 ...

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 ...

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 ...

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

... utilization of health benefits. * Obtains a thorough and accurate member history to develop an ... reviewing and providing input on the non-RN clinicians' performance on a regular basis. Minimum ...

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 ...

... 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 ...

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