20 Best jobs in trenton, nj (Hiring Now!)

Utilization Coordinator RN - FT - RMC
Capital Health —Trenton, NJ
Experience in case management field including utilization review, discharge planning, outcomes management, assessment, care planning, and/or care coordination.
Estimated: $71.8K - $90.9K a year
Ultrasonographer Perinat Adv - FT - Day - Maternal Fetal Medicine
Capital Health —Township of Hamilton, NJ
Acceptable certification or graduation from an accredited school of ultrasonography. Capital Health will require all applicants (including contractors,…
Estimated: $67.5K - $85.5K a year
Dental Assistant/EFDA
Smile Culture Dental —Fairless Hills, PA
Perform dental receptionist duties, including scheduling appointments and managing patient records. Dental assisting certification or relevant experience.
Estimated: $30.1K - $38.2K a year
Quick Apply
Support Broker
Public Partnerships LLC —Trenton, NJ
A valid driver’s license, access to a motor vehicle, and active vehicle registration, inspection and insurance certification required.
$47,500 - $50,000 a year
Quick Apply
Full-Time Dockworker - Inbound Shift
PITT OHIO —Township of Hamilton, NJ
We ask that all our Dockworkers perform all duties in accordance with company polices and procedures, and comply with all federal, state and local regulations…
From $24.26 an hour
Quick Apply
1d
Sandwich Artist
Subway - 28580-0 —Ewing, NJ
Physical: Ability to work any area of the restaurant as needed and to operate computerized Point of Sale system/cash register. Preparing and serving great food.
Estimated: $28.3K - $35.3K a year
Quick Apply
1d
Dental Assistant
CFG Health Network —Mount Holly, NJ
Maintains current CPR/AED certification. Complies with dental office security, the perpetual inventory, inspection of dental tools and completes corresponding…
Estimated: $39.2K - $49.6K a year
Utilization Mgmt Supervisor - FT - HPW
Capital Health —Pennington, NJ
Experience in case management field including utilization review and/or discharge planning, outcomes management, assessment, care planning, and care…
Estimated: $77.7K - $98.3K a year
Certified Pilates Reformer Director - New Brunswick
RWJ Fitness and Wellness Center —New Brunswick, NJ
We are looking to hire certified Pilates Reformer Director to support our state-of-the-art studio at RWJ Fitness & Wellness in New Brunswick.
Estimated: $41.4K - $52.5K a year
Quick Apply
Ultrasonographer (Perinatal) - Per Diem - Day - Maternal Fetal Medicine
Capital Health —Pennington, NJ
Acceptable certification or graduation from an accredited school of ultrasonography. Capital Health will require all applicants (including contractors,…
Estimated: $70.7K - $89.5K a year
Food Handler
LifeChef —Trenton, NJ
Term of Employment*: Full-time (40 hours per week), permanent placement. The Kitchen Associate will perform a variety of cross-functional services in support of…
$16 - $20 an hour
Quick Apply
Rehabilitation Assistant
Capital Health —Trenton, NJ
Capital Health will require all applicants (including contractors, travelers and consultants) to have an annual flu vaccine prior to start date, with the…
Estimated: $41K - $51.9K a year
1d
TWO-YR POSTDOCTORAL FELLOWSHIP - CLINICAL NEUROPSYCHOLOGY SPONSORED BY ACPN
Forensic Psychology and Neuropsychology Service, P.C. —Pennington, NJ
Forensic caseload includes plaintiff and defense IMEs in civil cases; criminal evaluations for not guilty by reason of insanity; diminished capacity; mitigating…
$55,000 a year
Quick Apply
General Dentist
ProSmile —Willingboro, NJ
Stay abreast with latest developments and techniques in the dental field. While performing the duties of this job, the employee is regularly required to stand,…
Estimated: $192K - $243K a year
Quick Apply
Certified Lifeguard at Chapin
ESF Camps —Princeton, NJ
Required Training: Complete all required ESF and state-mandated training and onboarding. Hours: Typically, from 8:15 am to 3:40 pm, Monday to Friday, with…
Estimated: $28.3K - $35.8K a year
Quick Apply
Front Desk Agent
Homewood Suites by Hilton —Township of Hamilton, NJ
As a Front Desk Agent, your responsibilities will include greeting and assisting guests, managing reservations, handling phone calls, and ensuring overall guest…
From $16.50 an hour
Quick Apply
Clinical Psychologist
New Jersey Department of Health - Ann Klein Forensic Center —Trenton, NJ
EXPERIENCE: *Three (3) years of experience in the field of clinical psychology in a community mental health center, mental hospital, school for the…
Estimated: $114K - $144K a year
Quick Apply
Office Assistant
J.W. Kennedy Fire Protection, LLC —Trenton, NJ
Monitor incoming emails and answer or forward as required. Take and distribute accurate messages. Maintain office filing and storage systems.
From $18 an hour
Quick Apply
Sandwich Artist
Subway - 26720-0 —Township of Hamilton, NJ
Physical: Ability to work any area of the restaurant as needed and to operate computerized Point of Sale system/cash register. Preparing and serving great food.
Estimated: $28.3K - $35.3K a year
Quick Apply
Chiropractic Office Assistant/Receptionist
Burlington Chiropractic —Burlington, NJ
When applying applicants MUST complete the phone assessment to be considered for the position.*. Computer and people skills helpful.
$18 - $20 an hour
Quick Apply
3d

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Utilization Coordinator RN - FT - RMC

Capital Health - Trenton, NJ

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Job Details

Full-time Estimated: $71.8K - $90.9K a year

Qualifications

Microsoft Excel
Utilization review
RN License
5 years
Content management systems
Case management
AS400
Discharge planning

Full Job Description

Work Shift:

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Position Overview:

SUMMARY (BASIC PURPOSE OF THE JOB)

Coordinates the Utilization Review function for Capital Health related to third party reimbursement, denials and appeals and clinical audits. Ensures responsibility for the Performance Improvement, Utilization Manager productivity, and Quality Improvement activities in the department. Ensures responsibility for all regulatory readiness and preparation activity in the department.

MINIMUM REQUIREMENTS

Education: Graduation from an accredited School of Registered Nursing.

Experience: Five years of experience in nursing. Experience in case management field including utilization review, discharge planning, outcomes management, assessment, care planning, and/or care coordination.

Other Credentials:Registered Nurse - NJ

Knowledge and Skills:Knowledge of CMS guidelines, payor specific guidelines, contractual rules, and applicable clinical guidelines. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.

Special Training:Word Processing, Spreadsheet software. Ability to use electronic mail, AS 400 system and other Utilization Management software and patient information software.

Mental, Behavioral and Emotional Abilities:

Usual Work Day:8 Hours

REPORTING RELATIONSHIPS

Does this position formally supervise employees? Yes

If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS

Monitors the inpatient utilization process and ensures that the process is performed adequately on all inpatients in accordance with applicable standards, regulations and payer contracts.
Manages the denial and appeal process for the department.
Interfaces with the Health Information Management (HIM) and Patient Finance departments to coordinate clinical components to ensure appropriate reimbursement.
Performs accurately chart and utilization review audits as directed.
Supports the Capital Health Utilization Committee with analysis of clinical outcomes data.
Exercises discretion and judgement to evaluate, develop and implement computer based data systems to support the utilization management and reporting functions. Prepares accurate and timely reports on all data collected as directed that demonstrates the effectiveness of the utilization program.
Prepares for and maintains accurate records of utilization audits by payors and QIO.
Maintains current and accurate knowledge of relevant CMS, NJDHSS, DOBI and QIO regulations related to managed care and utilization.
Coordinates the training of staff in utilization management processes ensuring staff expertise and performance.
Participates in Joint Commission (TJC) and other regulatory readiness and preparation activity, as directed.
Develops departmental performance improvement projects.
Manages the UM physician advisor program at Capital Health.
Oversees the denial life cycle process for the department. Enters and updates denials into the UR software system.
Reviews all denial entries daily for accuracy (Admission, Continuous Stay, Dropped Level of Care and Retrospective Audit). Corrections made when applicable.
Reviews and updates denial status from pending and open denials (concurrent reconsideration and peer-to-peer review) to sending denials for formal appeals daily.
Extracts denials from the UR software system and prepares them in a excel spreadsheet to be electronically submitted for retrospective appeal.
Updates appeal status upon notification. Manages, reports and writes retrospective Medicaid Appeal Audit denials.
Prepares and submits the written appeal to the auditing agency.
Monitors, tracks, manages and completes the retrospective audit denial appeals process.
Track denial life cycle tracking and monitoring using an excel electronic platform.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Sitting , Standing , Keyboard use/repetitive motion

Occasional physical demands include: Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities

Continuous physical demands include:

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing

Anticipated Occupational Exposure Risks Include the following: Bloodborne Pathogens , Chemical , Airborne Communicable Disease

IND123

Offers are contingent upon successful completion of our onboarding process and pre-employment physical. Capital Health will require all applicants (including contractors, travelers and consultants) to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions.

"Company will never ask candidates for social security numbers or date of birth during application phase. If you are asked for this information online, you may be a target for identity theft."

Apply Now

jobs in trenton, nj

Utilization Coordinator RN - FT - RMC

Ultrasonographer Perinat Adv - FT - Day - Maternal Fetal Medicine

Dental Assistant/EFDA

Support Broker

Full-Time Dockworker - Inbound Shift

Sandwich Artist

Dental Assistant

Utilization Mgmt Supervisor - FT - HPW

Certified Pilates Reformer Director - New Brunswick

Ultrasonographer (Perinatal) - Per Diem - Day - Maternal Fetal Medicine

Food Handler

Rehabilitation Assistant

TWO-YR POSTDOCTORAL FELLOWSHIP - CLINICAL NEUROPSYCHOLOGY SPONSORED BY ACPN

General Dentist

Certified Lifeguard at Chapin

Front Desk Agent

Clinical Psychologist

Office Assistant

Sandwich Artist

Chiropractic Office Assistant/Receptionist

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