Top 124 utilization review nurse Jobs in hackensack nj

SENIOR ANALYST HEALTH HOME
SBH Health System —Bronx, NY
- $110,000 - $114,000 a year
- Full-time
- Background check
- Anatomy knowledge
- Management
- Health insurance
- Dental insurance
Quick Apply
Patient Chart Reviewer
Vital Care Solutions Inc —Flushing, NY
- $40 - $46 an hour
- Part-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply
Case Management Care Coordinator, Utilization Management
Hackensack Meridian Health —Hackensack, NJ
- From $113,609.60 a year
- Full-time
- Nursing
- RN License
- Computer literacy
- Health insurance
- Dental insurance
4d
Nurse Registered Utilization Management- Part Time
St. Joseph's Health —Paterson, NJ
- $49.18 - $73.77 an hour
- Part-time
- Nursing
- RN License
- Bachelor of Science
- 403(b) matching
- Paid holidays
8d
Nurse Practitioner
Heritage NY Medical, PC —Brooklyn, NY
- $250 - $1,800 a day
- Part-time
- HIPAA
- Outpatient
- Clinic
- Flexible schedule
Quick Apply
MDS Coordinator Part time
Brooklyn United Methodist Church Home —Brooklyn, NY
- $50 - $55 an hour
- Part-time
- Anatomy knowledge
- HIPAA
- Mid-level
- Free parking
- Paid time off
Quick Apply
Utilization Review Nurse
HAMASPIK CHOICE INC —Spring Valley, NY
- $45 - $47 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Registered Nurse Supervisor
Mountainside Nursing and Rehab —Mountainside, NJ
- $40.04 - $48.22 an hour
- Full-time
- Nursing
- Medication administration
- Patient monitoring
- Health insurance
- Dental insurance
Quick Apply
RN – Home Health | Hybrid (3 Days in Person 2 Days Remote) - Flexible scheduling
Sante Allie —Jackson Heights, NY
- $54 - $55 an hour
- Contract
- Hybrid work
- Background check
- RN License
- Mid-level
Quick Apply
10h
Utilization Review Nurse (Medicare)
HAMASPIK CHOICE INC —Spring Valley, NY
- $41 - $47 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Care Manager - ED
Resource Logistics, Inc. —Bronx, NY
- $65 - $72 an hour
- Contract
- Nursing
- RN License
- 5 years
Quick Apply
16h
Nurse Manager, RN - MedSurg Telemetry - Mount Sinai Morningside - Full-time Days
Mount Sinai Morningside —New York, NY
- $115,494 - $173,241 a year
- Full-time
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse Case Manager - LTSS - Field in Union County NJ
Aetna —Union, NJ
- $66,575 - $142,576 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply
3d
Advanced Practice Registered Nurse
Boca Recovery Center —Englewood, NJ
- On call
- CPR Certification
- Nursing
- Psychiatry
- Disability insurance
- Health insurance
Quick Apply
4d
RN – Home Health | Hybrid (3 Days in Person 2 Days Remote) - Flexible scheduling
Sante Allie —Canarsie, NY
- $54 - $55 an hour
- Contract
- Hybrid work
- Background check
- RN License
- Mid-level
Quick Apply
10h
Bilingual Spanish Case Management
Little Treasures —Brooklyn, NY
- $28,000 - $45,000 a year
- Part-time
- Spanish
- Nursing
- HIPAA
- Health insurance
- 401(k)
Quick Apply
RN-Care Manager
NETPACE Health —White Plains, NY
- $60.63 - $76.96 an hour
- Weekends as needed
- Nursing
- RN License
- Computer literacy
- 403(b) matching
- Relocation assistance
Quick Apply
13h
MDS Coordinator
Alvin Kahn and Associates LLC —Cranford, NJ
- $110,000 - $125,000 a year
- Full-time
- Skilled nursing facility
- RN License
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Nurse Practitioner
Winston Support Services LLC —Nyack, NY
- $88 - $92 an hour
- Part-time
- Nursing
- HIPAA
- Outpatient
Quick Apply
Utilization Review (MDS) – RN/LPN
Confidential Healthcare Facility —Valley Stream, NY
- $90,000 - $125,000 a year
- Full-time
- Hybrid work
- Skilled nursing facility
- RN License
- Mid-level
- Opportunities for advancement
Quick Apply
1d

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utilization review nurse jobs near hackensack nj

SENIOR ANALYST HEALTH HOME

SBH Health System -
Bronx, NY

Quick Apply

Job Details

Full-time
$110,000 - $114,000 a year

Benefits

Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Paid time off
Employee assistance program
Employee discount
Retirement plan

Qualifications

Supervisory support in social service case management
Anatomy knowledge
Teamwork
Management
Medicare
Utilization review
Interdisciplinary collaboration in health services social work
Quality of care (regulatory compliance area)
Managed care organization experience
Social work
HIPAA
Managing patients as a nurse case manager
Transitional care planning in clinical case management
Acute care facility experience
Supervising experience
Health insurance knowledge
Medicare regulations
Case management
Utilization management
Healthcare privacy protection
End-of-life care
Centers for Medicare and Medicaid Services (CMS)
Substance abuse
Resource utilization in healthcare
Health information regulatory compliance
Organizational skills
Regulatory readiness in healthcare
Clinical documentation standards
Clinical data analysis
Healthcare performance metrics analysis

Full Job Description

Job Summary
We are seeking a highly skilled and dedicated Senior Analyst for our Health Home program. The ideal candidate will possess extensive experience in healthcare analysis, case management, and behavioral health, with a strong understanding of hospital operations, patient care coordination, and managed care principles. As a Senior Analyst, you will lead efforts in data collection, utilization review, and care planning to optimize patient outcomes and ensure compliance with healthcare standards. Your leadership will be instrumental in advancing our health home initiatives by integrating clinical expertise with analytical proficiency.

Responsibilities

Conduct comprehensive patient assessments to inform individualized care plans, integrating medical, behavioral health, and social determinants of health.
Lead utilization review processes to evaluate appropriateness of services and ensure adherence to Medicare, NCQA standards, and HIPAA regulations.
Oversee the review of medical records and documentation to maintain accuracy, completeness, and compliance with regulatory requirements.
Collaborate with multidisciplinary teams—including social workers, nurses, physicians, and behavioral health specialists—to coordinate discharge planning and post-acute care services.
Develop and monitor care management strategies that address complex patient needs within hospital settings such as Level I Trauma Centers, Level II Trauma Centers, PICUs (Pediatric Intensive Care Units), and emergency departments.
Manage data collection efforts related to patient care metrics, quality improvement initiatives, and behavioral health interventions to support program evaluation and reporting.
Provide leadership in supervising case management staff, fostering professional development while ensuring high standards of patient care delivery.
Ensure compliance with all relevant healthcare regulations including HIPAA privacy rules while maintaining meticulous medical records documentation.

Requirements

Proven experience working within hospital environments such as trauma centers, ICU units, emergency medicine departments, or pediatric intensive care units.
Strong background in nursing or healthcare analysis with familiarity in acute care settings including hospice care and home health services.
Knowledge of behavioral health practices including mental health counseling and addiction counseling techniques.
Experience in managing complex cases involving social work, discharge planning, and behavioral therapy interventions.
Familiarity with managed care principles, Medicare policies, NCQA standards, and utilization review processes.
Excellent understanding of medical terminology, anatomy, physiology, and patient assessment methodologies.
Demonstrated leadership skills with supervising experience in healthcare teams or case management programs.
Ability to analyze data effectively for quality improvement initiatives while ensuring compliance with HIPAA regulations.
Strong organizational skills combined with the ability to communicate clearly across multidisciplinary teams in fast-paced hospital environments. Join us in delivering exceptional patient-centered care through innovative analysis and collaborative leadership within our dynamic healthcare setting!

Pay: $110,000.00 - $114,000.00 per year

Benefits:

Dental insurance
Employee assistance program
Employee discount
Flexible spending account
Health insurance
Paid time off
Retirement plan
Tuition reimbursement

Work Location: In person

Quick Apply

Refine Your Search

utilization review nurse jobs in hackensack nj

SENIOR ANALYST HEALTH HOME

Patient Chart Reviewer

Case Management Care Coordinator, Utilization Management

Nurse Registered Utilization Management- Part Time

Nurse Practitioner

MDS Coordinator Part time

Utilization Review Nurse

Registered Nurse Supervisor

RN – Home Health | Hybrid (3 Days in Person 2 Days Remote) - Flexible scheduling

Utilization Review Nurse (Medicare)

Care Manager - ED

Nurse Manager, RN - MedSurg Telemetry - Mount Sinai Morningside - Full-time Days

Registered Nurse Case Manager - LTSS - Field in Union County NJ

Advanced Practice Registered Nurse

RN – Home Health | Hybrid (3 Days in Person 2 Days Remote) - Flexible scheduling

Bilingual Spanish Case Management

RN-Care Manager

MDS Coordinator

Nurse Practitioner

Utilization Review (MDS) – RN/LPN

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