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1,074 utilization jobs at 340 companies in Union City, NJ

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Utilization Review
Marlboro Township, New Jersey, United States
OnsiteFull Time
Discovery Institute of Addictive Disorders
Discovery Institute of Addictive Disorders: Provides professional drug and alcohol addiction treatment services.
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)
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3mo
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Director, Utilization Management
New York, New York, United States
$155k-$237k/yr OnsiteFull Time
Healthfirst
Healthfirst: Provides not-for-profit health insurance coverage to New York residents.
Senior-level leadership in utilization management with healthcare regulatory knowledge.
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1mo
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Utilization Management Coordinator
Piscataway, New Jersey, United States
$71k-$101k/yr HybridFull Time
Rutgers University
Rutgers University: Providing higher education degrees and conducting academic research.
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.
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1w
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Epic Tapestry Utilization Management
Boston or Chicago or New York City or Washington or Nashville
$85-$95/hr RemoteContract, Temporary
Chartis
Chartis: Strategic consulting and data analytics for the healthcare sector.
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
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3mo
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Care Coordinator, Utilization Management
Edison, New Jersey, United States
$106k/yr OnsiteFull Time
Hackensack Meridian Health
Hackensack Meridian Health: Provides comprehensive medical care through a network of hospitals.
Coordinate care, review utilization, communicate with payors to manage patient progression.
Epic, Xsolis Cortex, Enterprise Analytics, Google Suites
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2mo
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RN Utilization Review Specialist
Nyack, New York, United States
$110k/yr OnsiteFull Time
Montefiore Nyack Hospital
Montefiore Nyack Hospital: A community acute care medical and surgical hospital.
4+ YOENY registered nurse required; performs utilization management, discharge planning, concurrent reviews using Interqual, documents medical necessity, coordinates care across team; 4-6 years clinical experience preferred.
Interqual, Care Management database, H/C PRI/Screen
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1mo
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Placement & Utilization Support Coordinator
New York, New York, United States
$41k-$45k/yr HybridFull Time
MJHS
MJHS: Provides home health, hospice, and long-term care services.
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
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1mo
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Placement & Utilization Support Coordinator
New York, New York, United States
$41k-$45k/yr OnsiteFull Time
MJHS
MJHS: Provides hospice, home health, and skilled nursing care services.
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
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3mo
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Senior Manager, Utilization Management
New York, New York, United States
OnsiteFull Time
1199SEIU Funds
1199SEIU Funds: Administers health, pension, and training benefits for union members.
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
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2mo
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CHS Utilization and Appeals Manager
Melville, New York, United States
$110k-$150k/yr OnsiteFull Time
Catholic Health
Catholic Health: Provides comprehensive hospital and medical healthcare services.
5+ YOERN with 5+ years clinical/appeals experience; strong knowledge of utilization and care management; proficient in EPIC/Midas/Star; excellent communication and regulatory understanding.
EPIC, Midas, Star
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2mo
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CHS Utilization and Appeals Manager
Melville, New York, United States
$110k-$150k/yr OnsiteFull Time
Catholic Health
Catholic Health: Integrated healthcare system providing hospital and clinical medical services.
5+ YOERN with 5+ years in clinical utilization/care management and appeals; managed care experience; EPIC/Midas/Star familiarity; NY RN license; BSN preferred.
EPIC, Midas, Star, Word processing, Spreadsheet
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3d
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Acquisition Utilization Specialist
Smyrna or Fort Riley or Topeka or Salt Lake City or Seattle or Phoenix or Los Angeles or San Francisco or Denver or Washington or Miami or Atlanta or Chicago or Indianapolis or New Orleans or Boston or Minneapolis or Kansas City or Albuquerque or New York or Oklahoma City or Portland or Austin or Hot Springs or Waco
$75k-$123k/yr OnsiteFull Time
Department of Veterans Affairs
Department of Veterans Affairs: Provides healthcare, benefits, and cemetery services to military veterans.
1+ YOERequires one year of specialized procurement experience at the next lower federal grade, U.S. citizenship, and experience with acquisition strategy, contract compliance, procurement documentation, federal regulations, stakeholder coordination, and presentations.
Defense Travel System (DTS)
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4w
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Manager, Medical Utilization and Care Management
Charlotte or Denver or New York
$95k-$130k/yr OnsiteFull Time
Judi Health
Judi Health: Provides unified healthcare benefits administration and claims processing software.
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.
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1w
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Wound Care Utilization Management RN
Indianapolis or Iselin or Tampa or Miami or Wilmington or Cincinnati or St. Louis or Walnut Creek or Las Vegas or Woburn or Grand Prairie or Chicago or California or Illinois or Massachusetts or Nevada or New Jersey
$39-$56/hr RemoteFull Time
Elevance Health
Elevance HealthNYSE: ELV: Provides health insurance plans and integrated healthcare services.
3+ YOERequires an associate degree in nursing or equivalent background, 3+ years of healthcare experience, active unrestricted RN license, and wound-care certification such as WOCN or CWS.
medical records
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4w
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Vice President of Utilization Management
New York or New York or New Jersey or Connecticut
$252k-$277k/yr HybridFull Time
VillageCare
VillageCare: Provides managed long-term care and community-based health services.
10+ YOE8+ MgmtBachelor's in Nursing and Master's required, active unrestricted NYS RN license, 10+ years UM experience, 8+ years management, hospital clinical background, data analysis skills, and Medicare/Medicaid compliance experience.
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3d
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Utility Locator
Newark, New Jersey, United States
FieldFull Time
City of Newark
City of Newark: Municipal water and sewer utility services for Newark residents.
1+ YOEHigh school diploma or GED, New Jersey driver's license, and 1+ year relevant experience reading blueprints and maps. Requires GIS interpretation, utility infrastructure knowledge, locating devices, and utility plate familiarity.
Geographic Information System (GIS), locating devices
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2mo
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Utilization Review and Appeals Case Manager
Stony Brook, New York, United States
$90k-$128k/yr OnsiteFull Time
Stony Brook University
Stony Brook University: Provides public higher education, medical research, and healthcare services.
4+ YOERN with 3-5 years acute care; NY RN license;Bachelor's degree; knowledge of InterQual/MCG; strong communication; proficient in Word/Excel; weekend flexibility
Microsoft Word, Microsoft Excel, PowerPoint, Electronic Medical Records (EMR)
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2w
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Utilization Management Registered Nurse
Paterson, New Jersey, United States
$49-$74/hr OnsitePart Time
St. Joseph's Health
St. Joseph's Health: Provides comprehensive hospital care and specialized clinical health services.
3+ YOEBSN-required; NJ RN license; minimum 3 years nursing experience; utilization review/case management experience preferred; CCM certification preferred.
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1d
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Project Manager, Utilization Review
Parsippany-Troy Hills, New Jersey, United States
$100k-$125k/yr RemoteFull Time
Med-Metrix
Med-Metrix: Provides software and services for healthcare revenue cycle management.
4+ YOEActive RN license, utilization review and healthcare compliance experience, 3+ years of project management experience, data analysis tools, MCG and IQ expertise, and Microsoft Office proficiency.
MCG, IQ, Power BI, Microsoft Office Suite, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook
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1mo
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OP Enforcement Manager
New York or New York
$160k-$170k/yr OnsiteFull Time
Northeast Power Coordinating Council
Northeast Power Coordinating Council: Ensures the reliability of the interconnected bulk power system.
7+ YOEBachelor's in electrical or power system engineering,7+ years utility experience in planning or operations,PE or NERC operator cert preferred,ability to assess risk and communicate technical findings.
Microsoft Office
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