Utilization Review RN: Case Management & Compliance
01 The Valley Hospital
The Valley Hospital in Paramus, NJ seeks an Utilization Case Manager to perform concurrent utilization review, ensure medical necessity, and CMS compliance while collaborating with physicians and care coordination staff to support admission status decisions and optimize length of stay. Required is a NJ RN license and a BSN; experience in case management or utilization review is strongly preferred, with focus on regulatory requirements and payer guidelines. #J-18808-Ljbffr 01 The Valley Hospital
- ...Hospital in Paramus, NJ is seeking an Utilization Case Manager to perform concurrent reviews ensuring medical necessity and regulatory compliance. You will collaborate with physicians,... ...Requires BSN and an active New Jersey RN license; experience in case management...Suggested
- ...nurse to coordinate and facilitate patient care within a multidisciplinary team, utilizing resources effectively to support utilization review and case management. The role requires a RN licensed in New Jersey with a Bachelor’s degree; ANCC case management certification...SuggestedDay shift
- Valley Health System seeks a dedicated Utilization Case Manager at The Valley Hospital in Paramus, NJ.... ...You will perform concurrent utilization review, ensure medical necessity, and support... ...Requirements include BSN and an active NJ RN license; prior case management or...SuggestedHourly pay
- ...multidisciplinary team and oversee utilization of resources. The role focuses on case management and collaboration across care... ...include a Bachelor's degree and NJ RN licensure, with ANCC case management... ...or more years in utilization review or case management, plus five years...Suggested
- ...Job Description The Utilization Management Registered Nurse (UM RN) is responsible for evaluating the medical... ...care delivery while supporting compliance, quality outcomes, and effective... ...Preferred 3+ years of Utilization Review or Case Management experience. Case...SuggestedHourly payDaily paidFull timePart timeWorldwideShift work
- Opportunity: Case Manager Job Details: 13-week assignment Day shift... ...Assist patients and families in utilizing hospital resources to remove... ...Conduct utilization review and assure medical necessity... ...discipline per state guidelines (RN, RT, or SW preferred) required...Local areaDay shift
- VIBRA TRAVELS is seeking a Case Manager to join our expanding network... ...and regulatory agencies for review activities. Proficient in collecting... ...records. Knowledgeable in utilization review, medical terminology,... ...of regulatory standards and compliance requirements. Strong...Hourly payContract workLocal area
- Hackensack Meridian Health is seeking an RN Case Manager for per diem coverage in Hackensack, NJ. You will coordinate... ...ensure evidence-based practice and regulatory compliance. Responsibilities include discharge planning, utilization management, and communication with patients...Daily paid
$2,244.93 per month
...Nursing Profession RN Specialty Case Management Job ID 38508709 Job... ...Assist patients and families in utilizing hospital resources to remove barriers... ...timely completion of documentation and compliance with payor guidelines. Maintain...Weekly payContract workShift workDay shift- ...a Clinical Care Coordinator, Case Manager to coordinate patient progression... ...team to promote resource utilization, timely placement, and optimal... .... The role requires a BSN, RN licensure in New Jersey, and... ...case management and utilization review. #J-18808-Ljbffr 01 The...
- Clinical Management Consultants invites an experienced RN to become Nurse Supervisor Case Management at a Magnet-designated hospital in southern New York. Lead care... ...support case managers, and ensure efficient utilization review in a modern campus setting. This...
- ...care plans, resource utilization, and discharge planning... ..., and payors Support compliance, documentation, and quality... ...: Active RN license in the state of... ...practice (Required) Case Management Certification (Preferred... ...appropriate treatment Review resource utilization,...Shift workDay shift
- RN - Home Health Profession: Registered Nurse Specialty: Home... ...Home Health Blood Glucose management Cast/brace/immobilizer device... ...Medication management Nebulizer utilization and teaching Vital signs... ...for remote documentation and case management responsibilities.Candidates...Remote workShift workWeekend work
- ...Documentation Specialist RN facilitates... ...Health Information Management Department coding... ...going basis. The CDS reviews and screens ED... ...by the facility's Utilization Management/Review... ...completeness and compliance with patient status... ...with physicians, case managers, and nursing...
- ...Documentation Specialist RN facilitates... ...Information Management Department coding... ...going basis. The CDS reviews and screens ED inpatient... ...by the facility's Utilization Management/Review... ...completeness and compliance with patient... ...with physicians, case managers, and nursing...
- ...Case Manager Registered Nurse Join our team as a day shift, PRN, Case Manager Registered... ...Responsibilities The Case Manager RN is responsible for assessing and coordinating... ...patient care across the continuum, utilizing accepted criteria and guidelines to manage...ReliefDay shift
- ...seeking a Clinical Care Coordinator, Case Manager to coordinate patient progression, utilization management, discharge planning, admission status review, and transitions of care across the continuum... ...and compliant care delivery. BSN, NJ RN license, and case management...
- ...Case Management Services Provides case management as well as routine... ...of care. Job Duties Reviews all patient charts within 24... ...needs in accordance with the utilization/contractual requirements.... ...Requirements Current RN license in the state of NJ....Contract work
$2,374 per week
AMN Healthcare Nursing is seeking a travel nurse RN Case Management for a travel nursing job in Rochelle Park, New Jersey. Job Description & Requirements Specialty: Case Management Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type...Extra incomeTemporary workLocal areaImmediate startShift work- Pascack Valley Medical Center in Westwood, NJ is seeking a Day shift Case Manager RN (PRN option) to assess and coordinate patient care across the continuum. The role emphasizes utilizing criteria to manage benefits and determine medical necessity, while aiming to reduce...ReliefDay shift
- ...seeking a compassionate and experienced RN Hospice Case Manager to join our interdisciplinary team... ...care across disciplines, and ensuring compliance with hospice regulations and... ...standards and regulatory requirements Utilize WellSky EMR for timely and accurate charting...Full timeMonday to FridayWeekend work
$97.01k
...Minimum of two (2) or more years RN Experience. Minimum of three... ...by providing telephonic case management as well as quality, patient satisfaction... ...of treatments/procedures. Utilizes the nursing process (... ...clinical chart/ documentation review and triage, ensuring timely starts...Hourly payFull timePart timeApprenticeshipWork experience placementWork at officeLocal areaFlexible hoursShift workNight shiftWeekend workAfternoon shift$111k - $140k
...Hospital (LTACH) Director of Case Management Sign On Bonus: $10000... ...but not limited to: Utilization Review (UR) and resource management... ...management. Demonstrating compliance with facility-wide Utilization... ...you successful: Current RN licensure preferred. Working...Full timeWork experience placementRelocation packageMonday to Friday- ...Hospital-Paramus is seeking a Clinical Care Coordinator, Case Manager to oversee patient progression, utilization management, discharge planning, and transitions of... ...use and outcomes. The role requires a BSN and NJ RN licensure, with 5+ years of clinical nursing experience...
- ...part of an interdisciplinary team, performing wound care, device management and clinical assessments. The position requires NJ or compact... ...at least 1 year of home health experience; able to document remotely and handle case management tasks. #J-18808-Ljbffr Cynet HealthRemote jobShift work
- About This Role The Capacity Management RN is responsible for coordinating patient placement, access case management, and patient flow to ensure effective and efficient... ...implement the Capacity Management plan for the day. Review patient conditions for appropriate placement...Full timeDay shift
$79.1k - $105.95k
...to coordinate resource utilization and evaluation of services... ...participation and compliance in the program.* Documents... ...as the member is managed along the continuum of... ...Active Unrestricted NJ RN License Required.**Knowledge... ...* Working knowledge of case/care management principles...Live inLocal area- ...leader of positive change. The Capacity Management RN is responsible for all activities related... ...coordinating patient placement, access case management, and patient flow to ensure appropriate... ...continued focus on the day's plan. Reviews patient conditions as necessary, in...Afternoon shift
- ...on-call and weekends. As an RN with UPMC Home Healthcare, you... ...physicians, patients, and utilization management (UM) professionals to meet physicians... ...’ needs. RN will coordinate case management activities across... ...standards. Attend compliance training and adhere to the organization...Local areaWork from homeRelocation packageMonday to FridayFlexible hoursShift work
$50.18 - $62.73 per hour
...multidisciplinary approach to patient care and utilization of resources. Education Bachelor's degree required. ANCC case management certification preferred. Experience Minimum five years experience in utilization review management and/or case management preferred. Minimum...Hourly payFull timeTemporary workPart timeLocal areaFlexible hoursShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Review RN: Case Management & Compliance. Be the first to apply!


