1,106 utilization jobs at 389 companies in Princeton, NJ
1w
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Utilization Review
Marlboro Township, New Jersey, United States
OnsiteFull Time
2+ YOE2+ years utilization review, case management, medical billing, or behavioral healthcare experience preferred; high school diploma required; knowledge of Medicaid, commercial insurance, ASAM criteria; strong communication and organizational skills.
Microsoft Office, Electronic Health Record (EHR)
2mo
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Director, Utilization Management
New York, New York, United States
$155k-$237k/yr OnsiteFull Time
Senior-level leadership in utilization management with healthcare regulatory knowledge.
1w
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Utilization Review Coordinator
Allentown, Pennsylvania, United States
$20/hr RemoteFull Time
3+ YOEAssociate degree required, 3+ years utilization review or related healthcare experience, intermediate Microsoft Office/Excel skills, knowledge of precertification/appeals and medical records.
Microsoft Excel, Microsoft Word, Microsoft Office
1mo
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Utilization Management Coordinator
Piscataway, New Jersey, United States
$71k-$101k/yr HybridFull Time
3+ YOERequires RN license in New Jersey or Bachelor's in mental health, 3+ years mental health experience, utilization review and data entry skills preferred, ability to conduct reviews and communicate outcomes.
1d
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Utilization Management Nurse
Philadelphia, Pennsylvania, United States
$92k-$117k/yr OnsiteFull Time
5+ YOEAssess clinical data for medical necessity, coordinate utilization reviews, validate authorizations with payers and physicians; requires RN (PA), 5+ years acute clinical nursing, knowledge of payer processes and portal navigation.
Microsoft Office, InterQual
1d
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Epic Tapestry Utilization Management
Boston or Chicago or New York City or Washington or Nashville
$85-$95/hr RemoteContract, Temporary
Design, configure, implement, and support Epic Tapestry Utilization Management workflows; ensure regulatory compliance; perform testing and documentation; partner with clinical and operational teams.
Epic, Epic Tapestry, Tapestry Care Link, SmartTools, SmartText
1mo
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Utilization Management Nurse Registered
Woodland Park or Paterson
$49-$74/hr OnsiteFull Time
3+ YOEBachelor of Science in Nursing, NJ RN license, minimum 3 years nursing experience; 3+ years utilization review or case management preferred; CCM preferred.
4w
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Utilization Management Coordinator - Philadelphia
Philadelphia, Pennsylvania, United States
$28-$35/hr OnsiteFull Time
Conduct concurrent utilization reviews for psychiatric and residential drug/alcohol clients using ASAM criteria; coordinate appeals, maintain authorization and denial logs, and communicate with payers and treatment teams.
Microsoft Office
3mo
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Care Coordinator, Utilization Management
Edison, New Jersey, United States
$106k/yr OnsiteFull Time
Coordinate care, review utilization, communicate with payors to manage patient progression.
Epic, Xsolis Cortex, Enterprise Analytics, Google Suites
4w
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Utilization Management Coordinator - Philadelphia
Philadelphia, Pennsylvania, United States
$28-$35/hr OnsiteFull Time
Master's degree or nursing graduate with Pennsylvania licensure; knowledge of ASAM and medical necessity criteria; utilization review experience preferred; Microsoft Office and billing experience; strong communication and documentation skills.
Microsoft Office
3w
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Manager Utilization Review - FT - Day - Utilization Resource Mgmt Trenton NJ
Trenton, New Jersey, United States
$98k-$128k/yr OnsiteFull Time
4+ YOEBSN required (ADN with additional experience may be considered), active NJ RN, BLS recommended, 4+ years nursing experience with utilization review/case management, strong analytical and leadership skills.
1mo
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Utilization Specialist- OMY
Philadelphia, Pennsylvania, United States
OnsiteFull Time
2+ YOEBachelor's in human services/care management, 2 years mental health or social services experience, familiarity with EHRs, proficient with Microsoft Office, strong communication and analytical skills.
EHR, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
5d
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Utilization Review Coordinator – Behavioral Health
Toms River, New Jersey, United States
OnsiteFull Time
1+ YOEHigh school diploma (Bachelor's preferred), 1+ year behavioral health/treatment experience preferred, utilization review/authorization or billing experience preferred, strong communication and documentation skills, nursing/clinical background preferred.
1mo
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Placement & Utilization Support Coordinator
New York, New York, United States
$41k-$45k/yr HybridFull Time
1+ YOE1 year customer service experience required; healthcare experience preferred. Familiarity with utilization/case management, HealthRules Payor, Microsoft Word and Excel, 55 wpm typing, and strong customer service and interdisciplinary teamwork skills.
HealthRules Payor, Microsoft Word, Microsoft Excel
1mo
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Placement & Utilization Support Coordinator
New York, New York, United States
$41k-$45k/yr OnsiteFull Time
1+ YOE1 year customer service experience required; healthcare experience preferred. Familiarity with utilization/case management, HealthRules Payor, Microsoft Word and Excel; typing 55 wpm; strong customer service and interdisciplinary teamwork skills.
HealthRules Payor, Microsoft Word, Microsoft Excel
2mo
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Senior Manager, Utilization Management
New York, New York, United States
OnsiteFull Time
6+ YOE3+ MgmtBachelor's degree plus RN license; 6+ years in Utilization/Case Management/Appeals within managed care; 3+ years of leadership; Milliman guidelines knowledge; strong decision-making, communication, and MS Office skills.
Microsoft Office
2mo
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Utilization Review Assistant
New York, New York, United States
$27-$34/yr OnsiteFull Time
3+ YOEAdministrative support in healthcare; HS diploma or GED with 3 years experience or associate degree; strong organization; proficient in MS Office and EHR; excellent communication.
Microsoft Word, Excel, Electronic Health Records, Outlook
2w
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Utilization Review RN Per Diem
New Brunswick, New Jersey, United States
$51/hr OnsitePart Time
3+ YOEActive New Jersey RN license, 3+ years acute care nursing experience, ability to assess clinical records for medical necessity, strong communication and computer skills.
2w
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Director of Utilization Management
New York City or New Jersey or Connecticut
$118k-$133k/yr HybridFull Time
3+ YOE5+ MgmtMinimum 5 years management in health-related field, 3 years quality management, Bachelor's required (Master's preferred), active NYS RN license or willing to obtain within 3 months, experience analyzing data and knowledge of Medicare/Medicaid quality regulations.
3w
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Manager, Medical Utilization and Care Management
Charlotte or Denver or New York
$95k-$130k/yr OnsiteFull Time
5+ YOE2+ MgmtActive unrestricted RN license,5+ years in utilization/care/case management,2+ years leadership,knowledge of medical necessity reviews,care coordination,URAC/NCQA familiarity;CCM/CMGT-BC/HCQM preferred.