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The Workers' Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, and at times, attorneys to support the appropriate return to work, the provision of necessary medical services, and the evaluation of coverage under the Plan. The Nurse Case Manager reports to the Casualty Department Manager.
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The Care Manager serves as member’s advocate and accompanies the member throughout their care journey. The Care Manager is expected to assess and evaluate member’s needs, be a creative, efficient, and resourceful problem solver.
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As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health network includes over 27,000 primary care providers, specialists and participating clinics.
$120,000 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Montefiore Medical Center is seeking a Registered Nurse (RN) Case Management for a nursing job in Bronx, New York. Job Description & Requirements Specialty: Case Management Discipline: RN Duration: Ongoing Shift: days Employment Type: Staff RN Case Manager Coordinates the continuum of medical care services for patients to ensure optimum utilization of resources, delivery of quality patient care, and compliance with regulatory, accrediting and contractual requirements.
$58 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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STAFF: Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. Facilitate timely workup of patients for access management, dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination of care with the multidisciplinary renal team.
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Review and interpret varied and complex health care, clinical, utilization, and cost data to provide actionable insights to our providers. VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible.
Full-timeExpandApply NowActive JobUpdated 29 days ago - UpvoteDownvoteShare Job
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Experience with Care Coordination, Utilization review and discharge planning Computer literacy required. Specialty: Care Manager. Comprehensive care : Our healthcare recruitment team works for different specialties, so there is a job for everyone.
$47 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Under the Director of Nursing, the Nurse Manager is responsible for the clinical and operational management of assigned Nursing units, ensuring that standards of practice for nursing and patient care are maintained; participates in developing and implementing departmental plans and programs; supervises activities of assigned units; provides data and/or prepares reports on activities, QA, etc.
Full-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Program Manager, Licensed Brooklyn, New York Social Services Apply Now Job ID R011433 OverviewManages and oversees the administration of a Behavioral Health Services (BHS) program, including the appropriate utilization and management of staff and the quality of program participants care with an emphasis upon an inter-disciplinary team approach to the delivery of care.
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Role: Pharmacy Resident Job Location: New York City, NY Pay Range: $ 40/ Hr - $ 43/ Hr Job Summary: The Pharmacy resident is responsible for assisting the Clinical pharmacy manager with all aspects of formulary management, care management and utilization management strategies across all lines of business.
$40 - $43 an hourFull-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers’ Compensation and other Casualty clients. Provides case management, utilization review, continued stay reviews, and based on clinical judgment and state WCB Medical Treatment Guidelines.
$85,000 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Medix is currently hiring for a Utilization Review Nurse/Care Manager within a Healthcare system in NJ. It is 200 bed facility, which has been up to approx. We are looking for RN's that have strong inpatient clinical background or experience in Care Management/Utilization Review.
$100,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Financial Management The ANM collaborates with the Nurse Manager for efficient fiscal management of departmental activities to ensure proper utilization of hospital resources: Participates in Payroll, Staff Scheduling and daily staffing needs.
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Keep current on federal and state regulatory policies related to utilization management and care coordination (CMS guidelines, Health Plan policies, and benefits) Familiarity with care management, utilization/resource management processes and disease management programs.
$66.25 an hourFull-timeExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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The ANM collaborates with the Nurse Manager for efficient fiscal management of departmental activities to ensure proper utilization of hospital resources. The ANM, in collaboration with the Nurse Manager, assesses, plans, implements, monitors and evaluates nursing practice and the nursing care delivery system with direct supervision of front-line staff.
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care manager utilization jobs in West New York, NJ
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