- Current licensure as a Registered Nurse in the State of New Jersey
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registered nurse
2 days ago
Atlanticare Regional Medical Center, Inc. Egg Harbor Township, NJ , USA, United StatesPOSITION SUMMARY · The Perioperative Nurse is responsible for providing exceptional patient care and family support throughout the three phases of the surgical experience. This position provides the physician members of the healthcare team with the equipment, supplies and support ...
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registered nurse
1 week ago
DOCS Health Egg Harbor Township, NJ , USA, United StatesAttention all Registered Nurses, we are calling you to partner with us as independent contractors providing services to our Military Service members. · We primarily work weekends, with some occasional weekdays under the Reserve Health Readiness Program (RHRP) in the State of New ...
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registered nurse
2 days ago
Atlanticare Regional Medical Center, Inc. Egg Harbor Township, NJ , USA, United States Full time* Graduate of an accredited school of nursing required. · * Current licensure as a Registered Nurse in the State of New Jersey · POSITION SUMMARY · The RN Utilization Management Days is responsible for the overall Utilization Management process for assigned patient population. Th ...
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registered nurse
1 week ago
AtlantiCare Egg Harbor Township, NJ , USA, United States Full timeJob DescriptionGraduate of an accredited school of nursing required. · Current licensure as a Registered Nurse in the State of New Jersey · POSITION SUMMARY · The RN Utilization Management Days is responsible for the overall Utilization Management process for assigned patient pop ...
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registered nurse
1 week ago
AtlantiCare Egg Harbor Township, NJ , USA, United StatesJob Description · POSITION SUMMARY · The Perioperative Nurse is responsible for providing exceptional patient care and family support throughout the three phases of the surgical experience. This position provides the physician members of the healthcare team with the equipment, su ...
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registered nurse
1 week ago
Atlanticare Regional Medical Center, Inc. Egg Harbor Township, NJ , USA, United StatesPOSITION SUMMARY · The Perioperative Nurse is responsible for providing exceptional patient care and family support throughout the three phases of the surgical experience. This position provides the physician members of the healthcare team with the equipment, supplies and support ...
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registered nurse(rn)
2 days ago
MAS Medical Staffing Egg Harbor Township, NJ , USA, United StatesSeeking a(n) Registered Nurse (RN) professional with Registered Nurse (Hospice) experience for a week contract in the Egg Harbor Township NJ area. MAS Medical Staffing offers rewarding travel opportunities to healthcare professionals throughout the U Registered Nurse, Travel, Hos ...
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certified registered nurse anesthetist
1 day ago
AtlantiCare Egg Harbor Township, NJ , USA, United StatesJob Description · Join us in delivering exceptional care and advancing your career in one of the most dynamic healthcare environments in New Jersey. · Join the leading healthcare organization in South Jersey, AtlantiCare, as a Certified Registered Nurse Anesthetist (CRNA) and bec ...
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registered nurse surgery center or
1 week ago
AtlantiCare Egg Harbor Township, NJ , USA, United StatesJob Description · POSITION SUMMARY · The Perioperative Nurse is responsible for providing exceptional patient care and family support throughout the three phases of the surgical experience. This position provides the physician members of the healthcare team with the equipment, su ...
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certified registered nurse anesthetist
1 week ago
Atlanticare Regional Medical Center, Inc. Egg Harbor Township, NJ , USA, United StatesJoin us in delivering exceptional care and advancing your career in one of the most dynamic healthcare environments in New Jersey. · Join the leading healthcare organization in South Jersey, AtlantiCare, as a Certified Registered Nurse Anesthetist (CRNA) and become part of our es ...
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Atlanticare Regional Medical Center Egg Harbor Township, United StatesSurgery Center Perioperative Registered Nurse Endoscopy & Procedure Rooms · POSITION SUMMARY · The ENDO/Procedure Room Nurse is responsible for providing exceptional patient care and family support throughout the surgical experience. This position provides the physician members o ...
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AtlantiCare Egg Harbor Township, NJ , USA, United StatesJob Description · POSITION SUMMARY · The ENDO/Procedure Room Nurse is responsible for providing exceptional patient care and family support throughout the surgical experience. This position provides the physician members of the healthcare team with the equipment, supplies and sup ...
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Atlanticare Regional Medical Center, Inc. Egg Harbor Township, NJ , USA, United StatesPOSITION SUMMARY · The ENDO/Procedure Room Nurse is responsible for providing exceptional patient care and family support throughout the surgical experience. This position provides the physician members of the healthcare team with the equipment, supplies and support to perform su ...
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registered nurse
6 days ago
South Shore Health Weymouth, MA , USA, United StatesIf you are an existing employee of South Shore Health then please apply through the internal career site. · Requisition Number: · R-16130 · Facility: · LOC Columbian Street101 Columbian Street · Weymouth, MA 02190 · Department Name: · SSH Medical Oncology Cancer Center · Status: ...
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Registered Nurse
1 week ago
South Shore Health Weymouth, United StatesIf you are an existing employee of South Shore Health then please apply through the internal career site. · Requisition Number: · R-15992 · Facility: · LOC Fogg Road55 Fogg Road · Weymouth, MA 02190 · Department Name: · SSH Radiology Nursing · Status: · Part time · Budgeted Hours ...
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registered nurse
3 days ago
South Shore Health Weymouth, MA , USA, United StatesIf you are an existing employee of South Shore Health then please apply through the internal career site. · Requisition Number: · R-16133 · Facility: · LOC Columbian Street101 Columbian Street · Weymouth, MA 02190 · Department Name: · SSH Radiation Oncology Cancer Center · Status ...
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Registered Nurse
17 hours ago
South Shore Health Weymouth, MA, United StatesIf you are an existing employee of South Shore Health then please apply through the internal career site. · Requisition Number: · R-11283 · Facility: · LOC Fogg Road55 Fogg Road · Weymouth, MA 02190 · Department Name: · SSH Emergency Department HB · Status: · Full time · Budgeted ...
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registered nurse
1 week ago
South Shore Health Weymouth, MA , USA, United StatesIf you are an existing employee of South Shore Health then please apply through the internal career site. · Requisition Number: · R-14472 · Facility: · LOC Fogg Road55 Fogg Road · Weymouth, MA 02190 · Department Name: · SSH Obstetrics Birthing Unit · Status: · Full time · Budgete ...
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registered nurse
1 week ago
South Shore Health Weymouth, MA , USA, United StatesIf you are an existing employee of South Shore Health then please apply through the internal career site. · Requisition Number: · R-11907 · Facility: · LOC Fogg Road55 Fogg Road · Weymouth, MA 02190 · Department Name: · SSH Emergency Department HB · Status: · Part time · Budgeted ...
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registered nurse
4 days ago
South Shore Health Weymouth, MA , USA, United StatesIf you are an existing employee of South Shore Health then please apply through the internal career site. · Requisition Number: · R-16301 · Facility: · LOC Fogg Road55 Fogg Road · Weymouth, MA 02190 · Department Name: · SSH NICU · Status: · Part time · Budgeted Hours: · 0 · Shift ...
Registered Nurse - Egg Harbor Township, NJ, United States - Atlanticare Regional Medical Center
Description
Registered Nurse - Utilization Management - Full Time
Graduate of an accredited school of nursing required.
POSITION SUMMARY
The RN Utilization Management Days is responsible for the overall Utilization Management process for assigned patient population.
This includes reviewing clinical information to determine the appropriate level of care assignment, along with the completion and submission of reviews to insurance payers with appropriate follow-up.
The RN utilizes designated criteria/guidelines to determine and document the medical necessity and appropriate level of care.This position analyzes clinical information received to facilitate authorization from insurance providers, maximize reimbursement by preventing denials, and ensures clinical data is sufficient to obtain an authorization.
This position ensures that the obligation for clinical review is met according to the payer contracts and validates the accuracy of insurance information in the system.
The RN is knowledgeable of the payer contracting arrangements, admission notification and clinical review requirements, as well as the regulatory and compliance requirements for government payers regarding clinical reviews and medical necessity.
This role ensures that appropriate and accurate information is placed into the patient accounting system for processing of payment. This role also provides notification of denial issues and potential avoidance of a denial, along with changes in insurance information to all appropriate areas (e.g. clinical team, Patient Accounting).The RN supports system-wide improvement initiatives within the hospitals and the medical staff structure to ensure effective and timely performance improvement.
This role Participates in UR Committee work as requested.QUALIFICATIONS
EDUCATION:
Graduate of an accredited school of nursing required. Bachelor's in Nursing preferred. Case Management certification preferred.
LICENSE/
CERTIFICATION:
Current licensure as a Registered Nurse in the State of New Jersey
EXPERIENCE:
Prior case management/insurance case management experience preferred.
Proficiency in Clinical Applications preferred at time of hire; incumbents within position will be trained appropriately and then skill will be required for this position within 30-60 days from date of hire.
PERFORMANCE EXPECTATIONS
Demonstrates the technical competencies as established on the Assessment and Evaluation Tool.
WORK ENVIRONMENT
This position requires desk/computer work a majority of the time. There is some standing, walking and occasional lifting up to 20 pounds. The essential functions for this position are listed on the Assessment and Evaluation Tool.
REPORTING RELATIONSHIP
This position reports to department leadership.
The above statement reflect the general details considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.
