Top 4530 Manager implementation Jobs in Newark, Nj

Care Manager, Concurrent Review (Remote)
EmblemHealth —New York, NY
- $68,040 - $118,800 a year
- Remote
- Nursing
- Microsoft Outlook
- RN License
Program Manager
Amazon.com —Newark, NJ
- $81,600 - $142,800 a year
- Full-time
- Mid-level
- 3 years
- Recruiting
- AD&D insurance
- Health insurance
5d
RN Clinical Operations Manager - PACE Program (Care Delivery Manager)
CenterLight Health System —Brooklyn, NY
- $120,000 - $125,000 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Paid training
- Commuter assistance
Dialysis Clinical Manager - Registered Nurse
Cassena Care —Queens, NY
- $120,000 - $130,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN Clinical Operations Manager - PACE Program (Care Delivery Manager)
CenterLight Health System —Bronx, NY
- $126,000 - $132,000 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Paid training
- Commuter assistance
RN Unit Manager
Spring Grove Rehabilitation and Healthcare Center —New Providence, NJ
- $79,000 - $110,000 a year
- Full-time
- Nursing
- RN License
- BLS Certification
- Dental insurance
- Tuition reimbursement
Quick Apply
Case Manager - OPWDD Setting
Community Resource Center for the Developmentally Disabled —Yonkers, NY
- $26.52 an hour
- Full-time
- Management
- Computer literacy
- Basic math
- Health insurance
- Dental insurance
Quick Apply
Nurse Manager
Housing Works Inc —Brooklyn, NY
- $90,000 - $95,000 a year
- Spanish
- CPR Certification
- Nursing
- Health insurance
- Paid time off
Quick Apply
Clinical Nurse Manager - Ambulatory Surgery Center
Summit Health —Berkeley Heights, NJ
- $93,900 - $117,400 a year
- Full-time
- Nursing
- OSHA
- RN License
- Health insurance
- Dental insurance
Quick Apply
Assistant Group Home Manager
ARC Morris —Morris County, NJ
- $21.50 an hour
- Full-time
- Background check
- Clean driving record
- Mid-level
- Paid training
- 403(b) matching
Quick Apply
Senior Construction Project Manager with Site Work
Gemstar Construction Corp. —Staten Island, NY
- $80,000 - $150,000 a year
- Full-time
- Construction site
- Office
- Microsoft Office
- Health insurance
- Dental insurance
Quick Apply
APP Manager (NP or PA) - Medical/ Hem Oncology Office Practice - Staten Island - 8 hr Days
NYU Langone Health —Staten Island, NY
- $183,582.67 - $193,203.11 a year
- 8 hour shift
- Nursing
- RN License
- PALS Certification
- Wellness program
Lead Veterinarian
Flatbush Cats —Brooklyn, NY
- $170,000 - $175,000 a year
- Online Application
- Spanish
- English
- Clinic experience
- Commuter assistance
- Paid holidays
Quick Apply
11d
Territory Manager, Interventional Pain - New Jersey (Central / Northern NJ)
Avanos Medical —New Jersey
- $70,000 - $130,000 a year
- Weekends as needed
- Remote
- Marketing
- Hospital
- 5 years
- Health insurance
- 401(k) matching
Bilingual (Spanish) MSW Supervisor
Neighborhood Self-Help By Older Persons Project, Inc. —Bronx, NY
- $73,000 - $78,000 a year
- Weekends as needed
- Hybrid work
- Spanish
- Master of Social Work
- Computer literacy
- Health insurance
- Flexible spending account
Quick Apply
Dialysis Nurse Manager
Dialysis Clinic, Inc. —Staten Island, NY
- $93,600 - $130,000 a year
- Online Application
- Nursing
- RN License
- Mid-level
- Paid training
- Wellness program
Quick Apply
Registered Client Administrative Manager
Steward Partners Global Advisory LLC —New York, NY
- Full-time
- Mid-level
- Office
- Bachelor's degree
- Health savings account
- Health insurance
Quick Apply
5d
Associate Area Manager
KRE Group —Jersey City, NJ
- $135,000 - $145,000 a year
- Weekends as needed
- Office
- Residential
- Ability to climb stairs
- Health insurance
- Dental insurance
Quick Apply
LCSW Clinical Supervisor
Smith Arnold Partners —Bronx, NY
- $80,000 - $85,000 a year
- Full-time
- Background check
- Spanish
- Master of Social Work
- Health savings account
- Health insurance
Quick Apply
6d
Clinical Manager, Nurse Practitioner
VNS Health —Bronx, NY
- $64.88 - $87.00 an hour
- Full-time
- Spanish
- Nursing
- Psychiatry
- Continuing education credits
- Opportunities for advancement

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Care Manager, Concurrent Review (Remote)

EmblemHealth -
New York, NY

Apply Now

Job Details

$68,040 - $118,800 a year

Qualifications

RN License
Research

Full Job Description

Summary of Position

Perform clinical reviews within the Medical Management Operations Concurrent Review utilization management department.
Ensure accurate administration of benefits, execution of clinical policy and timely access to appropriate levels of care.

Principal Accountabilities

Under the direction of the leader, is responsible for the execution of efficient departmental processes designed to manage inpatient utilization within the benefit plan.
Act as the clinical coordinator collaborating with members and facilities to evaluate member needs within the inpatient setting.
Establish and maintain active working relationships with assigned facility care managers/utilization management departments to facilitate appropriate clinical reviews and patient care.
Enter and maintain documentation in the TPH platform meeting defined timeframes and performance standards.
Communicate authorization decisions and important benefit information to providers and members in accordance with applicable federal and state regulations, and NCQA and business standards.
Review and investigate member and provider requests to determine appropriate utilization of benefits and/or claim adjudication.
Research evidence-based guidelines, medical protocols, provider networks, and on-line resources in making coverage determinations and recommendations.
Prepare and present clinical case summaries in routine inpatient rounds.
Maintain an understanding of utilization management, program objectives and design, implementation, management, monitoring, and reporting.
Identify quality, cost and efficiency trends and provide solution recommendations to Supervisor/Manager.
Actively participate on assigned committees.
Perform other related projects and duties as assigned.

Qualifications

Education, Training, Licenses, Certifications

Associate’s degree or bachelor’s degree in nursing.
Valid RN License without restriction.
May require a CME accreditation in specific specialties.
Certification in utilization or care management preferred

Relevant Work Experience, Knowledge, Skills, and Abilities

4 – 6+ years of Nursing experience.
Case and/or utilization management/care coordination and managed care experience.
Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience.
Organizing and prioritizing skills, and strong attention to detail.
Trained in the use of Motivational Interviewing techniques.
Experience working in physician practice and/or with electronic medical records.
Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.).
Proficiency with the use of mobile technology (Smartphone, wireless laptop, etc.).

Additional Information

Requisition ID: 1000002996
Hiring Range: $68,040-$118,800

Apply Now

Refine Your Search

manager implementation jobs in newark, nj

Care Manager, Concurrent Review (Remote)

Program Manager

RN Clinical Operations Manager - PACE Program (Care Delivery Manager)

Dialysis Clinical Manager - Registered Nurse

RN Clinical Operations Manager - PACE Program (Care Delivery Manager)

RN Unit Manager

Case Manager - OPWDD Setting

Nurse Manager

Clinical Nurse Manager - Ambulatory Surgery Center

Assistant Group Home Manager

Senior Construction Project Manager with Site Work

APP Manager (NP or PA) - Medical/ Hem Oncology Office Practice - Staten Island - 8 hr Days

Lead Veterinarian

Territory Manager, Interventional Pain - New Jersey (Central / Northern NJ)

Bilingual (Spanish) MSW Supervisor

Dialysis Nurse Manager

Registered Client Administrative Manager

Associate Area Manager

LCSW Clinical Supervisor

Clinical Manager, Nurse Practitioner

I want to receive the latest job alert for manager implementation in newark, nj

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