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University Hospital, Newark
Newark, NJ, United States
Responsibilities The Director Utilization and Case Management will be responsible for the strategic direction setting, management, continuous improvement, and maintenance of the Utilization and Case Management Services Unit. This role evaluates the efficiency, appropriateness, necessity of the use of medical services, procedures, and level of care
Job Source: University Hospital, NewarkVillage Care
New York
Job Description Job Description Exciting Opportunity for experienced RN Utilization Management Leaders! As a Full Time Director of Utilization Management at VillageCare, you will have the unique opportunity to showcase your expertise in driving operational efficiency and ensuring quality patient care on a fully remote basis. Join our team of dedi
Job Source: Village CarePROMESA R.H.C.F.
New York
Job Description Job Description POSITION OVERVIEW: The Utilization Manager is responsible for the day to day functions of collaborative communication with external case managers at referring provider facilities and/or managed care organizations (MCO) for data collection, interpretation and certification/recertification from third party pa
Job Source: PROMESA R.H.C.F.Oscar Health
New York
Job Description Job Description Hi, we're Oscar. We're hiring a Senior Medical Director to join our Utilization Management Operations team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would w
Job Source: Oscar HealthAmerican Consultants
New York
Job Description Job Description Manager- Utilization Review/Case Management- NY American Consultants is looking for a permanent Manager of Utilization Review/Case Management for a facility in New York. Description: Assists the Director in overseeing the Utilization Management program within the hospital provided direct oversight for the Medical
Job Source: American ConsultantsElevance Health
Morristown, NJ, United States
Clinical Operations Medical Director Utilization Management of Medical Oncology Benefits Carelon Benefits Management $20,000 Sign On Bonus Location : The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations with the opportunity to work remotely from home. A proud member of the Elevance Health family of compa
Job Source: Elevance HealthElevance Health
Morris Township, NJ, United States
Clinical Operations Medical Director Utilization Management of Medical Oncology Benefits Carelon Benefits Management $20,000 Sign On Bonus Location : The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations with the opportunity to work remotely from home. A proud member of the Elevance Health family of compa
Job Source: Elevance HealthElevance Health
Iselin
**Clinical Operations Medical Director** **Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management** **$20,000 Sign On Bonus** **Location** : The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations with the opportunity to work remotely from home. _A proud member of the Elevance He
Job Source: Elevance HealthNewark, NJ, United States
Lead the Utilization and Case Management Department at University Hospital, a prestigious healthcare facility consistently recognized among the top hospitals in Northern New Jersey!
The Position
The Director of Utilization and Case Management will spearhead the strategic direction, management, continuous improvement, and overall maintenance of the Utilization and Case Management Services Unit.
Operating within a Dyad leadership model alongside the Director of Social Work, this leader will report directly to the Chief Operating Officer.
The ideal candidate will be a collaborative and highly visible leader with a desire to implement best practices in conjunction with the Director of Social Work and the Nursing Leadership team.
Preferred candidates will possess a robust background in handling appeals and denials, demonstrate strategic thinking abilities backed by tangible evidence. Additionally, candidates should exhibit strong teamwork skills and a commitment to fostering accountability among staff. Union experience is a plus.
This position requires full onsite presence; remote or hybrid work arrangements are not available.
Requirements
BSN degree required; master’s degree preferred.
Active NJ RN license required. License can be obtained by candidates relocating for the role.
Must possess at least five years’ experience working in an acute care setting, with at least two years’ experience in relevant leadership position.
The Organization
University Hospital is a separate, independent medical center with 519 licensed beds, an active medical staff of more than 600, and more than 3,100 employees.
The organization is home to northern New Jersey’s Level I Trauma Center and to specialty programs such as the Center for Liver Diseases and the Comprehensive Stroke Center.
University Hospital is a principal teaching hospital for Rutgers Biomedical and Health Sciences and a regional resource for specialized services and critical care.
For the first time, University Hospital, located in Newark, New Jersey, was designated as one of Newsweek's Best Maternity Care Hospitals 2021. This distinction, which recognizes hospitals that have excelled in providing quality care to mothers, newborns, and their families, as measured in part by the 2020 Leapfrog Hospital Survey, is part of Newsweek's Best Health Care series and powered by data from The Leapfrog Group.
As one of Newark’s largest employers, University Hospital plays a key role in the city’s economic and cultural renaissance.
University Hospital ranks among the Best Hospitals in Northern New Jersey and the New York Metropolitan area, according to Best Hospitals rankings, published by U.S. News & World Report. University Hospital is also recognized for "high performance" in the clinical specialty of Nephrology.
The Community
Newark, New Jersey, is divided into five geographical wards, and contains neighborhoods ranging in character from bustling urban districts to quiet suburban enclaves.
The metropolis offers a wide range of attractions including museums, parks, eateries, and New Jersey Performing Arts Center, one of the country’s largest and most glamorous performing arts venues.
From great museums, scenic parks and excellent restaurants to sports, theater and music, Newark offers plenty to see and do.
Newark is located just eight miles from the bustling metropolis of Manhattan, New York.
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Director of Utilization and Case Management jobs in Newark, NJ, United States
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