Description
Key responsibilities
- Lead, coach, and support the Central UR nurses and Insurance Specialists; manage assignments, workflow priorities, and staff performance.
- Ensure timely initial and continued-stay reviews, authorization follow-up, payer communication, and escalation of cases at risk for denial.
- Partner with physician advisors and care teams on level-of-care questions, peer-to-peer reviews, potential account downgrades, and clinical appeals.
- Analyze denial, appeal, authorization, and UR performance data to identify trends and lead corrective action.
- Work with hospital case management, medical, nursing, and revenue cycle leaders to resolve barriers and improve care progression.
- Identify recurring payer and Independent Review Organization issues and share findings with Managed Care Contracting and appeals leadership.
- Develop clear workflows, education, and tools in response to performance gaps, payer requirements, and regulatory changes.
- Monitor improvement plans and help teams sustain results across AHS hospitals.
Qualifications
Required
- Graduate of an accredited school of nursing with a current Registered Nurse license in the applicable state.
- Bachelors degree in nursing,
- Advanced degree in business, or health care administration preferred.
- Leadership experience in an acute care setting.
- Experience in acute care case management or utilization review.
- Strong clinical judgment, communication, data analysis, and team leadership skills.
Preferred
- ACM-RN or CCM certification.
- Experience with payer authorizations, clinical denials and appeals, and physician advisor workflows.
- Case management training through a professional organization.
About Us
At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:
- Atlantic Health Morristown Medical Center, Morristown, NJ
- Atlantic Health Overlook Medical Center, Summit, NJ
- Atlantic Health Newton Medical Center, Newton, NJ
- Atlantic Health Chilton Medical Center, Pompton Plains, NJ
- Atlantic Health Hackettstown Medical Center, Hackettstown, NJ
- Atlantic Health Goryeb Children's Hospital, Morristown, NJ
- Atlantic Health CentraState Healthcare System, Freehold, NJ
- Atlantic Medical Group
- Atlantic Visiting Nurse
- Atlantic Mobile Health
- Atlantic Rehabilitation
We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.
We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:
- Chosen for 17 years by Fortune as one of the magazine’s “100 Best Companies to Work For."
- Atlantic Health Morristown and Atlantic Health Overlook Named by Newsweek as two of the “World’s Best Hospitals” in 2026.
- Atlantic Health Morristown and Atlantic Health Overlook ranked within the top three hospitals in New Jersey by U.S. News & World Report’s 2025-2026 Best Hospital rankings.
- Atlantic Health scored four “A” grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.
- Atlantic Health Morristown and Atlantic Health Overlook are New Jersey's only hospitals to be named among America's 50 Best hospitals by Healthgrades in 2026.
- Named by Becker's Healthcare as one of the "165 Top Places to Work in Healthcare – 2026.
- Atlantic Health Morristown, Atlantic Health Overlook, Atlantic Health Chilton and Atlantic Health Newton all Forbes Top Hospitals for 2026.
- Named by Newsweek as one of America’s Greatest Workplaces for Inclusion & Diversity 2025.
- Atlantic Health rated LEVEL 9 - 2025 CHIME Digital Health Most Wired.
Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:
Team Member Benefits
- Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
- Life & AD&D Insurance.
- Short-Term and Long-Term Disability (with options to supplement)
- 403(b) Retirement Plan: Employer match, additional non-elective contribution
- PTO & Paid Sick Leave
- Tuition Assistance, Advancement & Academic Advising
- Parental, Adoption, Surrogacy Leave
- Backup and On-Site Childcare
- Well-Being Rewards
- Employee Assistance Program (EAP)
- Fertility Benefits, Healthy Pregnancy Program
- Flexible Spending & Commuter Accounts
- Pet, Home & Auto, Identity Theft and Legal Insurance
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Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.
EEO STATEMENT
Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran
