Utilization Manager Jobs in Newark
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Hackensack Meridian HealthNewark
documentation integrity, and utilization management. You will integrate clinical operations, data analytics, and payer strategy to drive measurable improvements in a large, tertiary academic medical center. This is a unique opportunity to shape clinical...
Inspira HealthNewark
clinical expertise and medical necessity criteria to perform the functions of utilization management, care coordination, resource utilization, and discharge planning. Must utilize established criteria to review appropriateness of admission and continued...
MetaSense, Inc.Newark
Job Description
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MetaSense, Inc. is seeking a travel nurse RN Case Management for a travel nursing job in Morristown, New Jersey.
Job Description & Requirements/n
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• Specialty: Case Management
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• Discipline: RN
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• Start Date: ASAP
/n...
HURCNewark
degree (Health Information Management, or a related field.
• 2–3 years of healthcare operations experience.
• 2-3 years of project management experience within healthcare, managed care, revenue cycle, utilization management, or healthcare consulting...
MetaSense, Inc.Newark
process Performs utilization management and quality screenings In- Patient Case Management is required
/n Skills : 2 years of acute care experience strongly preferred
/n Case Management, Managed Care. In Patient Case Management is required
/n Education...
Horizon Blue Cross Blue Shield of New JerseyNewark
to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.
About the Role
This position is responsible for handling all Utilization Management medical appeal cases...
Horizon Blue Cross Blue ShieldNewarkappcast.io
and exercise sound judgment.* Requires experience with utilization management, quality, payment integrity, case management, and/or medical policy.* Requires broad clinical skills to understand medical issues.## **Travel:*** Travel within NJ/NY/PA required...
Newarkicims.com
Overview:
About the Role:
The primary purpose of the Case Management Coordinator position is to coordinate the patient’s progress through the system. He/she collaborates with physicians and clinical staff to ensure resource utilization...
Renew360°Newark
with the Director of Nursing in addition to:
1. Medical Director
2. Director of Nursing
3. Clinical Director
4. Executive Director
5. Coordinator Utilization Management
6. Recovery Support Services
7. Pharmacy Consultant
8. Laboratory Services
9. Director...
RockstarNewarkworkable.com
understanding of VBC performance drivers, quality measures, utilization management, and shared savings models.
• Experience working closely with primary care practices and clinical teams.
• Demonstrated ability to lead and develop teams
• High comfort level...
Newarkicims.com
experience or equivalent combination of education and experience required to include two (2) years of direct clinical care OR two (2) years of case management/utilization management required.
Skills & Knowledge:
• Knowledge of workers' compensation laws...
Newarkicims.com
and practices utilization management.
Qualifications:
EDUCATION, EXPERIENCE, TRAINING
1. LCSW preferred; LPC, LCADC license for independent practice level required. (If the employee holds one or more of these licenses, primary source verification must...
Newarkicims.com
patient-focused Discharge Plan.
Qualifications:
Education and Work Experience
1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non-managed care environments.
2. Experience...
Newarkicims.com
and family including crisis intervention strategies, when indicated. Participates in interdisciplinary treatment team meetings, record keeping, and consultation and education. Develops interventions based on youth needs and practices utilization management...
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