Top 12913 Vendor Jobs in Jersey City Nj

Nurse Case Manager, Utilization Management
1199SEIU Family of Funds —New York, NY
- $89,400 - $106,100 a year
- Full-time
- Nursing
- RN License
- Mid-level
Commercial Claims Adjuster - Remote
WAHVE —New York, NY
- $35 - $60 an hour
- Part-time
- Remote
- Senior level
- Commercial
- Health insurance
- 401(k)
Estate Manager
MAHLER PRIVATE STAFFING —New York, NY
- $300,000 - $400,000 a year
- Weekends as needed
- Clean driving record
- Computer literacy
- Residential
- Food provided
Junior Accountant
Silver Slate Group —New York, NY
- $70,000 - $75,000 a year
- Full-time
- Microsoft Outlook
- Office
- Finance
- Health insurance
- Dental insurance
Quick Apply
6d
Warehouse Shipping Specialist
Novartis —Morris Plains, NJ
- $57,800 - $107,300 a year
- Full-time
- Mid-level
- High school diploma or GED
- Continuous improvement
- Health insurance
- 401(k) matching
Jersey City - Secure Concierge (SORA)
NFC Amenity Management —Jersey City, NJ
- $25 an hour
- Full-time
- US work authorization
- Entry level
- Paid training
- Disability insurance
Workplace Experience Senior
Freddie Mac —Jersey City, NJ
- $100,000 - $150,000 a year
- Full-time
- Hospitality
- 5 years
- Mid-level
Start Your Aviation Career | Customer Service Agent
Jet Aviation —Teterboro, NJ
- $22 - $23 an hour
- In-person
- Restaurant experience
- Entry level
- Disability insurance
- Dental insurance
Cabin Attendant- Floater - Teterboro, New Jersey
Jet Aviation —Teterboro, NJ
- $100,000 - $130,000 a year
- Part-time
- Hospitality
- CPR Certification
- Clean driving record
- Disability insurance
- Dental insurance
Farmers Market Vendor
CHOC O PAIN Bakery and Cafe —Jersey City, NJ
- From $15.92 an hour
- Part-time
- Ability to lift 50 pounds
- Organizational skills
- In-person
- Paid training
- Dental insurance
Quick Apply
Merchandise and Stocking Associate
Sam's Club —Secaucus, NJ
- $19 - $27 an hour
- High school
- Sales
- Merchandising
- Paid jury duty
- Disability insurance
Accounting Specialist
NJ Compensation Rating & Inspection Bureau —Newark, NJ
- $36 - $41 an hour
- Hybrid work
- Mid-level
- Finance
- Bachelor's degree
Quick Apply
5d
Administrative Assistant
Rutgers University —Newark, NJ
- $29.67 an hour
- Full-time
- Microsoft Access
- Office
- University
- Paid holidays
- Dental insurance
Administrative Assistant
Lackawanna Offices LLC —Montclair, NJ
- $25 an hour
- Part-time
- Microsoft Outlook
- Computer literacy
- Writing skills
Quick Apply
Administrative Aide II
New York University —New York, NY
- $39.13 an hour
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Office
Administrative Aide
New York University —New York, NY
- $39.13 an hour
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Office
Operations Support Specialist
BelovED Community & Empowerment Academy Charter Schools —Jersey City, NJ
- Full-time
- School experience
- Google Workspace
- Research
- Paid time off
Quick Apply
Data Entry Administrator
Academy Service Group —Hackensack, NJ
- Full-time
- Entry level
Quick Apply
AP Clerk - Newark, NJ
SUPPLYONE INC. —Newark, NJ
- $25 - $33 an hour
- Full-time
- Microsoft Outlook
- Customer service
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Program Manager, Vendor Management Operations
Oscar Health —New York, NY
- $111,780 - $146,711 a year
- Hybrid work
- Mid-level
- Office
- 4 years
- Paid parental leave
- Paid holidays
Quick Apply

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vendor jobs near jersey city nj

Nurse Case Manager, Utilization Management

1199SEIU Family of Funds -
New York, NY

Apply Now

Job Details

Full-time
$89,400 - $106,100 a year

Qualifications

RN License
Medical-surgical
Utilization management
Bachelor of Science in Nursing
Resource utilization in healthcare
Bachelor's degree in nursing

Full Job Description

Requisition #:

7440

# of openings:

Employment Type:

Full time

Position Status:

Permanent

Category:

Non-Bargaining

Workplace Arrangement:

Hybrid

Fund:

1199SEIU National Benefit Fund

Job Classification:

Exempt

Responsibilities

Use industry criteria, benefit plan design, clinical knowledge, and critical thinking to assess, plan and provide, ongoing coordination and management of service delivery through an integrated case management approach
Performs medical necessity review that includes concurrent, prospective, retrospective reviews and 1st level appeals, to ensure compliance with applicable criteria, medical policy, member eligibility, benefits and vendor contracts.
Apply Milliman Care Guidelines, internal Policies and Reference Guides to determine appropriateness of services/equipment that require Prior Authorization
Maintain accurate records of all patient/provider/vendor related interactions in designated medical management system
Apply clinical guidelines, provide recommendations and discuss cases with Medical Consultants
Meet timelines and quality standards related to Utilization Management
Maintain and submit reports and logs on reviewed activities as outlined by the UM program operational procedures,
Identify and participate in quality improvement activities as it relates to internal programs, processes studies and projects
Authorize vendor services using clinically proven criteria to make consistent care decisions
Maintain compliance with all state mandated regulations
Identify and problem solve issues with appropriate services to ensure positive member outcomes utilizing cost efficient covered services
Responsible for abiding by and supporting the care management programs in order to ensure quality and efficient clinical operations
Perform additional duties and projects as assigned by management

Qualifications

Bachelor’s degree Valid New York State Registered Nurse (RN) required
Minimum three (3) years Medical/Surgical experience plus a minimum of two (2) years Utilization Management experience required
BSN and Certification in Case Management a plus
Proficient in application and use of industry standard Utilization Management criteria (Milliman Care Guidelines), Medicare and coverage guidelines, health claims processing, medical coding
Excellent verbal and written communication skills, problem-solving, clinical assessment, care planning skills, and independent decision-making capability
Computer and organizational skills required, ability to manage competing priorities, multi-task with results-oriented outcomes and work in a fast paced environment. Intermediate skills of Microsoft Office systems preferred.

Apply Now

Refine Your Search

vendor jobs in jersey city nj

Nurse Case Manager, Utilization Management

Commercial Claims Adjuster - Remote

Estate Manager

Junior Accountant

Warehouse Shipping Specialist

Jersey City - Secure Concierge (SORA)

Workplace Experience Senior

Start Your Aviation Career | Customer Service Agent

Cabin Attendant- Floater - Teterboro, New Jersey

Farmers Market Vendor

Merchandise and Stocking Associate

Accounting Specialist

Administrative Assistant

Administrative Assistant

Administrative Aide II

Administrative Aide

Operations Support Specialist

Data Entry Administrator

AP Clerk - Newark, NJ

Program Manager, Vendor Management Operations

I want to receive the latest job alert for vendor in jersey city nj

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