Utilization Review Jobs in New Jersey
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Search Results - Utilization Review Jobs in New Jersey
Capital Health (US)-Pennington (NJ)
and basis for expectation of a 2 midnight stay). Refers cases as appropriate, to the UR physician advisor for review and determination.
• Gathers clinical information to conduct continued stay utilization review activities with payers on a daily basis...
Newark
for pre-authorization, concurrent reviews and appeals/denials management throughout the duration of a consumer’s stay. Assists the treatment planning team in understanding insurance requirements and completes UR audits for billing compliance...
icims.com -
2 similar jobs: Trenton, Jersey City
Valley Health System-Ridgewood (NJ)
Position Summary
Performs concurrent utilization review activities on all patients within the assigned caseload. Collaborates and educates the medical staff on appropriate utilization review guidelines and documentation in accordance with CMS...
Hampton Ridge Healthcare and Rehabilitation-Toms River
requirements
• Ensure timely and accurate electronic transmission to the state
• Attend and manage weekly utilization review meetings and maintain open communication with therapy and team members
• Participate in developing/updating/reviewing/completion...
Katalyst Healthcares & Life Sciences-Newark
/blood banking, utilization review and/or case management with critical care skillset knowledge preferred
CTBS Certified or willing to obtain within two years of employment.
We need an RN that has at least 5 years' experience in acute/critical care...
resume-library.com -
2 similar jobs: Trenton, Jersey City
Inspira Health Network-Mullica Hill
years of healthcare experience within the last 15 years; Management experience preferred
• 5+ years of case management and utilization review experience within the last 7 years
• Knowledge of MCG criteria and understanding of Centers for Medicare...
RWJBarnabas Health-Long Branch (NJ)
Required:
• BSN required.
• NJ RN License
• 3 to 5 years acute care RN experience
• Case Management experience
Preferred
• Utilization Review or Discharge Planning Experience
• Case Management Certification
Scheduling Requirements
• 8-4:30 or 9-5...
US Tech Solutions-Newark
Requires 5+ years of Medical Coding experience
• Requires a minimum of 5+ years’ experience in Health Insurance/quality chart audits and/or Utilization Review
Skills:
• Requires the ability to utilize a personal computer and applicable software (e.g...
mindmatch.ai -
Rutgers University-Stratford (NJ)
Overseeing patient assessment activities, utilization review, and quality assurance programs.
• Conducting regular patient record reviews to evaluate documentation quality and care/treatment appropriateness.
• Educating hospitalists on accurate patient...
appcast.io -
CareCentrix-East Brunswick (NJ)
As a Nurse Liaison you will be an expert in resource management, a master of utilization review and a compassionate partner for patients and their support network. You will be responsible for an assigned caseload at acute and post-acute care...
Concentra, Inc.-Newark
procedures, and performance standards and URAAC guidelines and state regulations.
Responsibilities
MAJOR DUTIES AND RESPONSIBILITIES:
1. Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity...
appcast.io -
Erickson Senior Living-Neptune (NJ)
Medication Errors, Restraint Utilization, Re-hospitalization, Anti-psychotic utilization, ADL splits/documentation, etc.
• Collaborating with Staff Development Coordinator to ensure all required training and competency reviews are completed according...
RWJBarnabas Health Corporate Services-Somerset (NJ)
responsibilities during emergent staffing needs.
• Monitors and assesses the use of hospital services by administering utilization review procedures under Federal, State and hospital guidelines.
• Participates in facilitating new hire orientation
• Participates...
Astera Cancer Care-East Brunswick (NJ)
with private, county and state resources to facilitate coordination or transitions. Case management duties also include service utilization review, quality improvement and community resource development activities.
• Support Groups: Facilitate 2-3 closed...
mindmatch.ai -
North Bergen
requirements and follows the state of New Jersey regulations for Nursing.
Responsibilities:
A day in the life of a Care Coordinator, Utilization Management at Hackensack Meridian Health includes:
• Follows departmental workflows for utilization review...
icims.com -
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