Utilization Review Jobs in Jersey City
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Search Results - Utilization Review Jobs in Jersey City
GainwellJersey City
and technical development academies
Responsibilities
• Provide clinical guidance on policies, drug utilization, and pharmacy operations
• Perform clinical evaluations of medication therapy including prior authorization reviews and DURs
• Conduct peer-to-peer...
Dane Street, LLCJersey Cityappcast.io
No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions.
• Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
• Expanded...
Integrated ResourcesJersey City
of institutional audit trends
• Conduct DRG validation and utilization review audits and per diem reviews
• Identify billing discrepancies and refer improper payments through appropriate channels
• Train new staff on audit procedures and department processes...
Dane Street, LLCJersey Cityappcast.io
is provided. These are advisory-only opinions.
• Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
• Expanded credentials as an expert in Independent Medical Exams
• Fully...
UnitedHealth GroupJersey City
or Marriage and Family Counseling or Licensed Ph.D. level Psychologist (independently licensed)
• Board certification as a Behavior Analyst (BCBA) and state licensure as required
• 3+ years of Managed Care and/or Utilization Review experience
• 3+ years...
Hackensack Meridian HealthJersey Cityappcast.io
cutting-edge technology to make a significant impact on patient care and hospital performance.
Key Responsibilities
• Provide Senior Leadership Serve as the primary advisor to the CMO, lead the JSUMC Physician Advisor team, and oversee Utilization Review...
ICBDJersey Cityworkable.com
Quality Assurance (QA), Utilization Review (UR), Assessments, Training & Development, and Research. Whether your passion is direct clinical impact, leadership, process improvement, or innovation, we provide opportunities to expand your skills and build a meaningful...
UnitedHealth GroupJersey City
and Pharmacy Utilization Review/trends
• Intermediate to advanced MS Office (Word, Excel, PowerPoint)
• Strong verbal and written communication skills
• Self-motivated with excellent time management and prioritization skills
• Remote work readiness per company...
CumminsJersey City
generation applications
• Lead project planning sessions with internal stakeholders to define scope, objectives, milestones, and performance goals
• Develop cross-functional schedules and resource plans to meet timelines and optimize utilization
• Review...
UnitedHealth GroupJersey City
requirements
• 5+ years of people leadership in a healthcare setting
• 3+ years in training program development, QA operations, or organizational education
• 3+ years in utilization management operations or utilization review
• 3+ years working knowledge...
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