Care Coordinator, Utilization Management Hackensack Meridian HealthCare Coordinator, Utilization ManagementEdison, New JerseyFull timeResponsibilities: A day in the life of a Care Management, Care Coordinator, Utilization Management at Hackensack Meridian Health includes: Follows departmental workflows for utilization review activities including admission reviews, admission denials, continued stay reviews, continued stay denials, termination of benefits, communication of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
Registered Nurse (RN) Case Manager I (Full-Time, Days) - Home Care Rochester Regional HealthRegistered Nurse (RN) Case Manager I (Full-Time, Days) - Home CareNewark, New JerseyWorks collaboratively with other care team members by communicating all changes in patient status and/or service needs to the appropriate care team member and ensures appropriate action is taken in a timely manner. Manages and coordinates patient care, including clinically complex cases, in a manner which ensures the efficient and effective delivery of appropriate services and community supports.
Clinical Document Improvement Specialist - FT - Day - Clinical Documentation Improvement Trenton NJ Capital HealthClinical Document Improvement Specialist - FT - Day - Clinical Documentation Improvement Trenton NJTrenton, NJ$39.40–$51.47 / hourExperience: Two years' recent clinical experience in an acute care setting, preferable ICU or Medical/Surgical, or three years related coding experience or clinical documentation improvement specialist experience in a hospital setting. Ensures that medical record documentation provides an accurate representation of the patient's clinical complexity, diagnoses, severity, and expected risk of mortality to support accurate DRG assignment and quality measure reporting.
Telehealth Family Nurse Practitioner - Eating Disorders (New Jersey-Remote) Equip Health IncTelehealth Family Nurse Practitioner - Eating Disorders (New Jersey-Remote)NJRemote$110,000–$140,000 / yearNurse Practitioners are essential members of Equips 5-person virtual treatment team, working alongside a therapist, dietitian, peer mentor, and family mentor to help people recover from eating disorders. The following are the required working hours: Ability to provide 30 hours a week of availability for direct patient care, including new patients and follow-up sessions.
Inpatient Clinical Denial Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ Capital HealthInpatient Clinical Denial Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJNJ$20.10–$26.13 / hourOther Credentials: Knowledge and Skills: Working knowledge of inpatient clinical denial categories, including medical necessity, patient status, and readmissions Familiarity with utilization review processes and clinical documentation workflows Ability to perform detailed tracking, documentation, and inventory management across multiple appeal levels Strong organizational skills and attention to detail Ability to identify root causes and recurring denial drivers Strong written communication skills for documentation and internal coordination Proficiency with hospital billing systems, EMR navigation, and payer portals Proficiency with Microsoft Office applications, including Excel. Ensures inpatient clinical denial cases are properly triaged, routed, documented, tracked, and prepared for appeal in accordance with payer requirements, while partnering with clinical and operational resources to support timely resolution and denial prevention.
Nursing Assistant - PRN/Per Diem AtlantiCare Rehabilitation HospitalNursing Assistant - PRN/Per DiemGalloway, New JerseyOur inpatient rehabilitation hospital is committed to providing exceptional and compassionate care to best address the medical, physical, emotional and vocational challenges for individuals with brain injuries, spinal cord injuries, neurological disorders, orthopedic issues, amputation and multiple traumas. Led by a physiatrist – a physician board-certified in physical medicine and rehabilitation – our team includes rehabilitation nurses; physical, occupational, and speech-language therapists; dietitians; case managers and other clinical and support staff.
["Client Care Coordinator-Home Care- Per Diem","Client Care Coordinator-Home Care- Per Diem"] Hackensack Meridian Health["Client Care Coordinator-Home Care- Per Diem","Client Care Coordinator-Home Care- Per Diem"]BelmarThe posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training.
Surgical Revenue Integrity Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ Capital HealthSurgical Revenue Integrity Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJNJ$44.37–$57.97 / hourReviews physician operative/procedural reports, implant/device logs, purchasing documentation, and billing detail to identify missing invoices, missing charges, documentation-to-charge mismatches, and related claim-readiness risks. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity.
Clinical Liaison - Inpatient Rehab - Per-Diem Kessler Institute for Rehabilitation - West (West Orange)Clinical Liaison - Inpatient Rehab - Per-DiemWest Orange, New JerseyIn this highly visible, challenging, and rewarding position, you will assume a leadership role, developing and nurturing professional relationships with case managers, physicians, and clinicians in acute care hospitals; educating staff, patients, and families regarding rehabilitation services provided by our rehabilitation hospital. Two years related experience working in a clinical healthcare setting or previous experience working in a clinical liaison role preferred.
Licensed Practical Nurse (Lpn) - PRN - Skilled Nursing - SNF Ellen Sagar Nursing Center Spartanburg Regional Medical CenterLicensed Practical Nurse (Lpn) - PRN - Skilled Nursing - SNF Ellen Sagar Nursing CenterUnion, NJOral and Written Communication- Speaks clearly and persuasively in positive or negative situations; listens for and seeks proper clarification; responds well to questions asked; demonstrates excellent group presentation skills; participates in meetings and enrichment discussions; writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet appropriate needs; presents numerical data effectively and legibly; and is able to read and interpret written information. Resident/Customer Service- Manages difficult or emotional resident/customer situations; responds promptly to resident needs; solicits resident feedback in an attempt to achieve an optimum level of resident care; treats people with respect; keeps commitments; inspires the trust of others; works with integrity and ethically; upholds organizational values.
Home Care Infusion RN- PT (Wed, Fri, Sat) Hackensack Meridian HealthHome Care Infusion RN- PT (Wed, Fri, Sat)Eatontown, New JerseyOr - Without previous experience or experience not within one (1) year: Will complete a vascular access device (VAD) course through HMH and follow up practicum experience in HMH outpatient infusion setting and return demonstration with preceptor inserting peripheral line, accessing ports, PICCs and central lines. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
OR Service Coordinator - F/T Day Hackensack Meridian HealthOR Service Coordinator - F/T DayRed Bank, New JerseyFull timeThe posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. Responsibilities: The OR Service Coordinator helps to plan, organize, and direct the specialty services within their service lines by establishing and preparing to deliver unique services in surgical care.
Join our Talent Community for Clinical Specialists in IV Spine Ferring Pharmaceuticals, Inc.Join our Talent Community for Clinical Specialists in IV SpineParsippany, NJDemonstrated experience supporting the launch of a novel or disruptive therapy, including leading initial case support, training physicians on procedural techniques, and driving adoption through clinical workflow integration across office, ASC, and hospital settings. Active cross functional partners and coordinate with account leads to support the educational and technical needs within target accounts to ensure development of procedural expertise and confidence to deliver consistent, repeatable administration.
NewPatient Education Liaison, Community - East (NJ, PA, VA, MD, NC, SC, DE) SanofiPatient Education Liaison, Community - East (NJ, PA, VA, MD, NC, SC, DE)Bridgewater, NJRemote$122,250–$176,583.33 / yearThe PEL will be building expertise for 7 brands, 5 therapeutic areas, understanding market conditions that impact the patient journey, understanding rare competitive products, engage in account strategy and planning with galaxy and constellation teams, advise the cross functional teams on the patient perspective, consider the account direction when making execution decisions, and developing skills sets that will allow them to compliantly bring patient insights back to leadership reducing the need for external insights gathering. Collaborate effectively, building and maintaining strong relationships with the Strategic Account Management cross-functional team (including Commercial, Medical, Marketing, and Case Management) to exchange insights and foster innovative ideas that enhance strategies for key account success.
NewPatient Education Liaison, Community - East (Nj, PA, VA, MD, NC, SC, DE) SanofiPatient Education Liaison, Community - East (Nj, PA, VA, MD, NC, SC, DE)Bridgewater, NJRemote$122,250–$176,583.33 / yearThe PEL will be building expertise for 7 brands, 5 therapeutic areas, understanding market conditions that impact the patient journey, understanding rare competitive products, engage in account strategy and planning with galaxy and constellation teams, advise the cross functional teams on the patient perspective, consider the account direction when making execution decisions, and developing skills sets that will allow them to compliantly bring patient insights back to leadership reducing the need for external insights gathering. Collaborate effectively, building and maintaining strong relationships with the Strategic Account Management cross-functional team (including Commercial, Medical, Marketing, and Case Management) to exchange insights and foster innovative ideas that enhance strategies for key account success.
LTSS Service Coordinator-RN Clinician Elevance HealthLTSS Service Coordinator-RN ClinicianIselin, New JerseyThe LTSS Service Coordinator RN Clinician is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Responsible for performing face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
Authorization Integrity Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ Capital HealthAuthorization Integrity Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJLawrenceville, NJ$35.69–$46.63 / hourWorks high-risk scheduled and procedural accounts (for example OR, Cath Lab, IR, advanced imaging, and other prior-auth-dependent services) and coordinates timely corrections with Central Scheduling, clinical departments, physician offices, and revenue cycle teams. Supports retro-authorization and post-service correction workflows where permitted; routes non-correctable cases to the appropriate Denials team pathway after pre-bill controls are exhausted.
DRG Downgrade Clinical Documentation Improvement - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ Capital HealthDRG Downgrade Clinical Documentation Improvement - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJNJ$39.40–$51.47 / hourKnowledge and Skills: Expert knowledge of DRG methodology and clinical indicators supporting principal diagnosis and complication/comorbidity (CC/MCC) capture Strong familiarity with payer and third-party audit firm DRG downgrade methodologies Working knowledge of ICD-10-CM/PCS concepts as they relate to DRG assignment (coding credentials not required) Ability to identify documentation gaps and support compliant provider query opportunities Strong written and verbal communication skills for clinical documentation clarification and education Ability to collaborate effectively with physicians, CDI teams, clinical appeals staff, and non-clinical denial specialists Proficiency with electronic medical records and CDI tools. Focuses on prevention and defense of DRG downgrades initiated by payers and third-party audit firms through comprehensive documentation review, provider query support, and collaboration with clinical and denial management teams to support accurate DRG assignment and appeal success.
NewPharmacist - Per Diem AtlantiCare Rehabilitation HospitalPharmacist - Per DiemGalloway, New JerseyLed by a physiatrist – a physician board-certified in physical medicine and rehabilitation – our team includes rehabilitation nurses; physical, occupational, and speech-language therapists; dietitians; case managers and other clinical and support staff. Responsibilities: As the Pharmacist, you will be responsible for having a working knowledge of all areas of pharmaceutical services including drug distribution systems, central operations and IV admixture.
NewCase Manager Registered Nurse - Field (Monmouth/Ocean) County, NJ CVS HealthCase Manager Registered Nurse - Field (Monmouth/Ocean) County, NJTrenton, NJRemote$66,575–$142,576With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.