Pre-Authorization LPN - Managed Care & Care Coordination
MJHS
MJHS seeks a licensed practical nurse in Paterson, NJ to process elective service requests, out-of-network and durable medical equipment referrals within Utilization Management. You will apply Medicare criteria, coordinate with Care Managers, and ensure timely authorizations and documentation to support claims and care continuity. In this role, you’ll communicate admissions and authorizations to Care Managers, document decisions for claims and data integrity, and support discharge planning with #J-18808-Ljbffr MJHS
- ...Medicare and Medicaid managed care health plans, are outstanding... ...Management Coordinator and/or Care Manager to... ...care. Ensures that authorizations are appropriate, and determinations... ...Management during the pre-authorization,... ...Program; current LPN NY license and registration...Suggested
- ...nurse to support our Medicare/Medicaid managed care initiatives. You will process requests for... ...and durable medical equipment, and coordinate with Utilization Management and Care Management... ...program credential, a current NY LPN license, 1-3 years of Medical/Surgical experience...Suggested
- MJHS is seeking an experienced Licensed Practical Nurse (LPN) to support Elderplan and HomeFirst initiatives in an ambulatory or managed care setting. The role focuses on pre-authorization, utilization management, and discharge planning to ensure continuity of member care...Suggested
- ...Newark is seeking a licensed practical nurse (LPN) to support Medicare and Medicaid plans through pre-authorization, concurrent review, and discharge planning. You will process service requests, coordinate with care managers, and help ensure accurate authorizations and...Suggested
- ...LPN Patient Program CoordinatorThe LPN Patient Program Coordinator is responsible for coordinating day-to-day program operations... ...physicians, clinical staff, and program management, facilitating communication and... ...throughout the patient care process.Essential ResponsibilitiesOversee...SuggestedWork at office
- ...Health Technology Transforming Care Hudson Regional Health is... ...& Specialty Care - coordinated care across multiple disciplines... ...What You'll Be Doing The LPN – Patient Program Coordinator... ...clinical staff, and program management, facilitating communication and...Local area
- ...guidelines and departmental criteria. The role requires an accredited Practical Nursing Program, active LPN license, 1-3 years medical/surgical experience (managed care preferred), and familiarity with utilization management. Strong communication and analytical skills...
- ...Regional Health in Secaucus, NJ, is seeking a dedicated LPN – Patient Program Coordinator to coordinate day-to-day program operations and oversee... ...between patients, physicians, clinical staff, and program management, facilitating communication, scheduling, documentation,...
- ...minimum three (3) years of medical case management or similar experience. Previous case management... ...complex patients in a hospital critical care setting and supervisory experience.Our... ...reviews.Building relationships and coordinating with payor sources in order to ensure proper...Full timeWork experience placementRelocation packageMonday to Friday
$50 per hour
...Recovery Hospital (LTACH) Case Manager (PRN) Pay: $50/hr Requires a... ...providing compassionate, excellent care every step of the way.... ...reviews. Builds relationships and coordinate with payor sources to assure proper... ...either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist...Daily paidFull timePart timeReliefShift workWeekday work$91k - $104k
...Job Description NOW HIRING: RN/ LPN Evening Nurse SupervisorSHIFT: Full... ...Responsibilities: Oversee and manage nursing staff to ensure high-quality care. Conduct assessments and develop... ...a positive work environment. Coordinate with other healthcare professionals...Full timeImmediate startShift workAfternoon shift- ...is to provide direct nursing care to the residents, and to supervise... ...other resident services when coordinating nursing services to ensure... ...or inspections made by authorized government agencies, as may be... ...or graduate from an approved LPN/RN program.Experience Not applicable...Work at officeLocal areaRelocation packageShift work
- ...is America’s top cosmetic surgery specialist, seeking an LPN/LVN to support patient care before, during, and after procedures. You will assist surgical... ...-quality patient experiences. Responsibilities include pre-op/post-op visits, patient education, and maintaining...
$40 per hour
...Licensed Practical Nurse (LPN) – Multiple Pediatric Home Care Cases (Wayne, Pompton... ...Transportation and care coordination assistance Monday, Tuesday... ...home setting Monitor and manage tracheostomy and... ...Current BLS Certification Authorized to work in the United States...Permanent employmentFull timePart timeFlexible hoursShift workNight shiftWeekend workAfternoon shift- ...Licensed Practical Nurse (LPN) Principal Care Management (PCM) Join Elaya Health Improving Specialty Care in Nursing Homes Remote Position... ...Review patient charts, medications, labs, and care plans Coordinate care with providers, nursing staff, pharmacies, and...Full timePart timeRemote workFlexible hours
$85k
...Community Director – LPN | Senior Living $85,000/annually |... ...County, NJ | Fox Trail Memory Care Start a rewarding career with... ..., and coach team members Manage staff schedules to ensure adequate... ...to maintain occupancy Coordinate smooth move-ins and a welcoming...Full timeTemporary workWork at officeLocal area- ...time employment, being a member of our TLC Care Team offers a unique opportunity to do... ...Responsibilities Participate in the planning and coordination of total patient care in conjunction with... ...1 year experience as an LPN in a home care setting Current state license...Full timePart timeLocal areaFlexible hours
$21.78 per hour
...restrictions. Our Claims Examiner III LPN protects the integrity of the... ...patterns. Develop and manage investigative cases, including... ...within the MVH program. Perform pre-payment and post-payment reviews... ...necessity, appropriateness of care, and compliance with MVH policy...Contract workFor contractorsLocal areaImmediate startRemote workMonday to FridayFlexible hoursShift work- ...supported to make a real impact.Directs nursing care for the patients, and supervises the day-... ...or is a graduate of an approved LPN program required as evidenced by primary... ...Assists the Director of Nursing Services to coordinate the care planning/MDS process and committee...ReliefLocal areaNight shiftWeekend work
$56k - $80k
...ladder above. Key Responsibilities Coordinate discharge planning alongside case management, social work, and the patient's... ...discharges through insurance authorization before the bed is needed Mentor... ...have in NJ. We are prioritizing Care Plan Development talent right now...TraineeshipRemote workFlexible hours- ...being of every team member. Our Legacy Formerly Hamilton Health Care System, Vitruvian Health is built on a legacy of trust,... ...attending physicians. Assists the Director of Nursing Services to coordinate the care planning/MDS process and committee meetings as...ReliefNight shiftWeekend work
- ...health services include home care, hospice and palliative care for... ...assessment, medication management and patient/family education. Under the direction of a Coordinator of Care RN, the Licensed Practical... ...prescribed plan of care NY State LPN License required Minimum of...Relocation package
$45 per hour
...Pediatric Registered Nurse (RN) & Licensed Practical Nurse (LPN) Flexible Pediatric Home Care (Paramus, NJ) Location: Paramus, NJ Setting:... ...home care or acute care) Current BLS Certification Authorized to work in the United States Valid driver’s license preferred...Immediate startFlexible hoursWeekend workAfternoon shift$75k - $90k
Skilled Wound Care | Newark, NJ + Extensive Regional... ...Practical Nurse (LVN/LPN) to join our growing team... ...development, account management, and healthcare operations... ...grow existing ones Coordinate scheduling and logistics... ...complete a confidential pre-employment DiSC...Full timeNight shift- ...Allergy Consultants P A seeks a RN/LPN to join our team in Verona, NJ. You will create and manage individualized care plans, observe patients, document changes, and communicate effectively to support patient welfare. The role requires current nursing licensure in New...Flexible hours
- ...Benefits Flexible Scheduling 1:1 Care Paid Sick Time Paid Time Off... ...care, ventilator management, and tube feedings. Works collaboratively... .... Participates in the coordination of care and attends Agency meetings... ...to practice as an RN or LPN in the state of operation. Current...Local areaFlexible hours
- ...Health Services, is seeking a Licensed Practical Nurse (LPN) to join our team. The role involves 12-hour shifts... ...Director of Nursing, you will assess residents, develop care plans, supervise staff, and coordinate daily unit operations to ensure high-quality care and regulatory...Flexible hoursShift work
- ...Medication Administration"Performs point-of-care laboratory tests, EKGs as ordered or... ...Village Medical offers paid parental leave, pre-tax savings on commuter expenses, and generous... ...of healthcare for providers and patients.LPN Pay Range: $33.99 - $42.50Pay Range: $40.3...
- ...Seeking a qualified Nurse Manager / Unit Manager for our skilled... ...facility. Includes overseeing the care management of a population of... .... The Unit Manager coordinates resource utilization, timely and... ...Must be a licensed Nurse RN or LPN Benefits Medical, Vision...
- ...Part-Time LPNs for day shifts (11am-7pm) to join our team in a skilled nursing facility. Under RN leadership, the LPN will provide coordinated patient care and ensure timely treatments. The role includes supervising CNAs, transcribing orders, administering medications...Part timeDay shift
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