RN Utilization Management: Clinical Review & Compliance

AtlantiCare

AtlantiCare in Egg Harbor Township, NJ, is seeking a Registered Nurse for Utilization Review. The role involves analyzing clinical data, ensuring medical necessity, and coordinating with insurance payers. You'll support hospital initiatives and participate in the Utilization Review Committee. Qualifications include a nursing degree, NJ RN license, and MCG certification. BLS certification and prior case management experience are preferred. The position offers benefits such as generous PTO, insurance coverage, and tuition reimbursement. #J-18808-Ljbffr

Apply

Vacancy posted 1 day ago

Similar jobs that could be interesting for youBased on the RN Utilization Management: Clinical Review & Compliance in Egg Harbor, NJ vacancy

RN Utilization Review Specialist - Payer Compliance & Denials
...is seeking a Registered Nurse for Utilization Review. The role involves analyzing clinical data and coordinating with... ...'s degree in nursing and current RN licensure in New Jersey. Responsibilities... ...Advisors and maintaining compliance with payer requirements. The position...
Suggested
AtlantiCare
Egg Harbor, NJ
1 day ago
RN Utilization Management: Elevate Care & Reimbursement
$84.24k - $124.8k
...a dedicated Registered Nurse for Utilization Management in Egg Harbor Township, New Jersey... ...entails managing the utilization review process, analyzing clinical data for insurance authorization,... ...Bachelor's in nursing and a current RN license in New Jersey. Experience...
Suggested
RadNet
Egg Harbor, NJ
1 day ago
Clinical Program Director (RN Required)
$96.9k - $128.5k
...through our out-patient clinic partnerships... ...responsible for the management and the strategic... ...performance reviews. (5%) Performs... ...through appropriate utilization and management of... ...requirements, including compliance requirements, and... ...Registered Nurse (RN) license to be maintained...
Suggested
Work at office
Night shift
Healogics
Somers Point, NJ
4 days ago
Registered Nurse - Utilization Management - Full Time
$84.24k - $124.8k
...Registered Nurse - Utilization Management - Full Time #07-39591 Egg Harbor Twp, New Jersey, United... ...Job Description POSITION SUMMARY The RN Utilization Management is responsible... ...patient population, including reviewing clinical information to determine the appropriate...
Suggested
Full time
Temporary work
Flexible hours
RadNet
Egg Harbor, NJ
1 day ago
Registered Nurse - Utilization Management - Per Diem
...POSITION SUMMARY The RN Utilization Management is responsible for the overall Utilization Management... ...patient population. This includes reviewing clinical information to determine the... ...requirements, as well as the regulatory and compliance requirements for government payers...
Suggested
Daily paid
Temporary work
Flexible hours
AtlantiCare
Egg Harbor, NJ
4 days ago
Registered Nurse - Utilization Management - Full Time
...Perform the Registered Nurse Utilization Review for an assigned patient... ...population, including analyzing clinical data to determine... ...decisions, and maintain regulatory compliance for government payers.... ...utilization / insurance case management experience preferred; experience...
Full time
Temporary work
Flexible hours
AtlantiCare
Egg Harbor, NJ
1 day ago
Nursing Education Clinical Operations Lead
...time faculty only. The Clinical & Operations... ...logistics, partnerships, and compliance requirements for the nursing... ...clinical faculty and manages the day‑to‑day... ...Coordinate simulation and lab utilization to support clinical... ...unencumbered Registered Nurse (RN) license in New Jersey...
Daily paid
Full time
Summer work
Flexible hours
Afternoon shift
Atlantic Cape Community College
Mays Landing, NJ
1 day ago
RN Clinical Manager
...supervision and coordination of clinical services. Coordinates and... ...properly and timely, as required. Reviews clinician visit notes weekly... ...appropriateness of care and utilization of services, equipment, and... ...Additional Information Current RN licensure in state of New...
CPA Recruiter Online
Egg Harbor, NJ
1 day ago
Acute Dialysis Services Program Manager - RN
...monthly treatments. Utilizes the FMC mission,... ...level of efficiency management. PRINCIPAL... ...including performance reviews, development,... ...customer. Ensures compliance with hospital regulations... ...program for all clinical and technical... ...School of Nursing (RN); Advanced degree...
Full time
Temporary work
Work experience placement
Night shift
Weekend work
Fresenius Medical Care
Atlantic City, NJ
2 days ago
Registered Nurse RN
$83k - $124.49k
...prescribed by the physician and in compliance with applicable laws,... ...Primary Responsibilities: Clinical Competence Initiates,... ...in the agency's utilization management model ~ Ability to function... ...Current and unrestricted RN licensure in state of practice...
Hourly pay
Weekend work
Genoa Telepsychiatry
Egg Harbor, NJ
4 days ago
Medical-Surgical Registered Nurse (Med-Surg RN)
...Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans, Implements,... ...Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review. # Performs Other Duties As Assigned...
Yale New Haven Health
Pleasantville, NJ
8 hours ago
Cardiology RN Clinical Manager - Lead Care & Quality
...AtlantiCare Regional Medical Center in Egg Harbor Township is seeking a full-time RN Clinical Manager for cardiology services. This leadership role oversees clinical operations, ensures quality patient care, and supports team development within the cardiology service line...
Full time
AtlantiCare
Egg Harbor, NJ
1 day ago
RN Weekend Supervisor
...RN Weekend Supervisor Excelcare at the Pines is seeking an... ...Supervisor who provides leadership and clinical oversight for weekend... ...nursing staff, maintains regulatory compliance, and promotes a safe,... ...patient care when necessary Manage admissions, discharges, and transfers...
Shift work
Weekend work
ExcelCare at The Pines
Atlantic City, NJ
4 days ago
Travel Nurse RN - Cardiovascular Operating Room - $2,922 per week in Pomona, NJ
$2,922 per week
...Registered Nurse (RN) | Cardiovascular Operating Room Location... ...Benefits Package Clinical Support Extra Ways To Earn... ...allied health, and therapy talent management solutions for top healthcare... ...payroll to clinical support to compliance. FlexCare pushes...
Full time
Contract work
Immediate start
Shift work
TravelNurseSource
Pomona, NJ
12 days ago
Clinical Supervisor, LPN
$26 - $40 per hour
...Clinical Supervisor, LPN At Axia Women's Health,... ...patient care, regulatory compliance, and consistent... ...necessary. Create and manage staff schedules (including... ...Perform phone triage, review laboratory results,... ...reported signs and symptoms, utilizing established triage...
Full time
Temporary work
Work at office
Shift work
Rotating shift
Axia Women's Health
Egg Harbor, NJ
4 days ago
Psychiatric Intervention RN: Prevention & Care Leader
$42.5 - $62 per hour
...with the Physician. The Registered Nurse utilizes the nursing care process consistent with... ...Programs. EXPERIENCE: Proficiency in Clinical Applications preferred at time of hire;... ...psychosis, etc.. Endoscopy Chronic pain management, endoscopic procedures of cardiovascular...
Temporary work
Part time
Flexible hours
Shift work
Weekend work
AtlantiCare
Egg Harbor, NJ
2 days ago
RN Case Manager - PRN
$41 - $46 per hour
...Per Diem Registered Nurse Case Manager (RNCM) Our Holisticare... ...detail-oriented Registered Nurse (RN) to be a Hospice Case Manager... ...organize, and direct hospice care utilizing the nursing process of... ...standards of professional nursing and clinical competency. We are committed...
Hourly pay
Daily paid
Relief
Afternoon shift
Holisticare Hospice
Pleasantville, NJ
15 days ago
Operating Room Team Leader RN with Growth & PTO
$37.54 - $60 per hour
...education, consultation, evidence‑based clinical practice, and leadership. The Perioperative... ...issues, participating in performance reviews, developing and implementing performance... ...Associate (SGNA) and American Society of Pain Management Nursing (ASPMN) preferred. Ability to...
Hourly pay
Full time
Temporary work
Part time
Flexible hours
RadNet
Egg Harbor, NJ
1 day ago
Registered Nurse- Operating Room
...Operating Room RN Jersey Shore Ambulatory Surgery Center, located... ..., spine surgery, pain management, and general surgical procedures... ...procedures. The center maintains full compliance with the New Jersey... ...Jersey Shore ASC combines the clinical excellence of a skilled, multispecialty...
Hourly pay
Part time
Weekend work
Broughton Group
Somers Point, NJ
1 day ago
Physician Associate Medical Director Hospice
...assessments with patients. Manage symptoms and provide... ...for acute patient clinical problems that cannot be... ...ensuring ethical and legal compliance in all aspects of care... .... Assist in reviewing policies to improve care... ...patients. Participate in utilization reviews and periodic...
Local area
Amedisys
Linwood, NJ
5 days ago
Center Manager/LPN
...Center Manager The Center Manager will perform under the supervision of the Operations... ...good health of donors through the compliance with Food and Drug Administration (FDA)... ...internal Company procedures Regular review and updating, as needed, of center documentation...
Work at office
Flexible hours
B Positive Plasma
Egg Harbor, NJ
4 days ago
Assistant Director of Nursing ADON
...The ADON helps oversee daily clinical operations, supports nursing... ...development, promotes regulatory compliance, and fosters a positive, team... ...City, NJ 08234 Must Be an RN Assistant Director of... ...Responsibilities: Assist in managing and supervising the nursing...
ExcelCare at The Pines
Egg Harbor, NJ
3 days ago
Registered Nurse - Pleasantville Clinic
$32.93 - $40.58 per hour
...in collaboration with the physician. The RN utilizes the care process consistent with their license... ...preferred. BLSHCP required. Child Weight Management RN requires PALS within 1 year of hire or transfer. Experience: 3-5 years clinical experience preferred; demonstrated...
Full time
Temporary work
Flexible hours
Shift work
RadNet
Pleasantville, NJ
1 day ago
RN Team Lead: Elevate Nursing Care & Compliance
...organization in New Jersey is seeking a dedicated Registered Nurse Manager to lead their nursing team in delivering high-quality patient... ...supervising staff, developing nursing policies, ensuring compliance with regulations, and enhancing patient care standards. This role...
Preferred Care Health Centers
Galloway, NJ
1 day ago
Assistant Director of Nursing (LPN / RN)
$10k
...community Understands and reviews the community's Healthcare Clinical Policies and Procedures Ensures compliance with local, state, and... ...state as a Registered Nurse (RN) or Licensed Practical Nurse... ...) Experience in nursing management in Assisted Living/ Memory...
Temporary work
Local area
Flexible hours
Priority Life Care
Egg Harbor, NJ
2 days ago
Registered Nurse Clinical Director - Behavioral Health - Full Time
...in the State of New Jersey * BLSHCP * Certification within area of specialty preferred * Minimum 5-7 years combined clinical and management experience in nursing * Solid understanding of TQM, organizational vision and values * Strong interpersonal, communication...
Full time
Temporary work
Flexible hours
AtlantiCare
Egg Harbor, NJ
4 days ago
Associate Clinical Nurse Manager - 4 Meadow Acute Care/Post-Surgical Unit
$86.75k - $151.81k
...protected veteran status. Description Position Summary The Associate Nurse Manager ensures expert nursing care delivery supporting staff education, achievement of quality outcomes, evidence-based clinical practice, and leadership. The Associate Nurse Manager supervises team...
Full time
Temporary work
Flexible hours
Shift work
Weekend work
AtlantiCare
Egg Harbor, NJ
1 day ago
RN Clinical Manager Cardiology
...POSITION SUMMARY The RN Clinical Manager- Cardiology serves as a clinical and operational leader for cardiology services, supporting ambulatory patient care standards and quality improvement initiatives. This role ensures the delivery of high-quality, cost-effective...
Temporary work
Work at office
Flexible hours
AtlantiCare
Galloway, NJ
4 days ago
Psychiatric Nurse Practitioner For Spravato & TMS Clinic: South NJ 1
...Practitioner to join our Oasis team in clinics in South Jersey, full-time.... ...the administration and management of Spravato (esketamine) and... ...evaluations, including a review of medical and psychiatric history... ...medical records, ensuring compliance with clinic protocols, ethical...
Full time
Immediate start
OASIS MENTAL HEALTH CENTERS MEDICAL LLC
Northfield, NJ
1 day ago
RN Clinical Coordinator - Field Based in Atlantic County, NJ
$40 - $54 per hour
...RN Clinical Care Coordinator At UnitedHealthcare, we're simplifying the health care experience... ...Coordinator will be the primary care manager for a panel of members with complex... ...needs to promote appropriate utilization of services and improved quality of care...
Hourly pay
Minimum wage
Full time
Work experience placement
Local area
Flexible hours
UnitedHealthcare At Home
Atlantic City, NJ
5 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to RN Utilization Management: Clinical Review & Compliance. Be the first to apply!