Rutgers New Jersey Medical School
Clinical Affairs - Office of Managed Care
Welcome to the site for the Office of Managed Care. This site will provide Rutgers New Jersey Medical School (NJMS) faculty and staff the tools to answer general questions related to managed care operations and provider contracts. Here you will find information related to credentialing, referrals, and provider agreements. If your questions or concerns are not answered here, please refer to the For More Information section to contact the Office of Managed Care.
Who Should Use This Site?
This site is designed as a tool for faculty and staff seeking information related to physician credentialing, precertification, preauthorization, and referral information. You may also access limited information regarding billing, claims, provider agreements, and managed care contracts.
Please note: This site is a tool designed to provide general information only. For detailed or specific information, please contact the member's health plan, utilization management, or the Rutgers NJMS Faculty Practice Clinical Affairs-Office of Managed Care.
Managed Care Organizations
Click the link for a list of health plans.
To visit an insurance web site directly, click the name of the specific health plan.
Click the link for a list of contact information for select health plans.
Referral, Precertification, and Preauthorization Requirements
Click the link to review referral, precertification, and preauthorization requirements listed by insurance.
Click the link to locate a participating LabCorp or Quest Diagnostics laboratory in New Jersey.
This online tool allows providers to test whether or not they would successfully demonstrate meaningful use for the EHR (Electronic Health Record) Incentive Programs. Click here to visit the Medicare and Medicaid EHR Incentive Program website for more detailed information about the program, including who is eligible to participate (CMS.gov).
Click the link to connect to the Rutgers Legacy UMDNJ login page. Access web-based resources such as email and important employee information.
|Role||Responsibilities||Phone/ Fax/ Email|
Justin Sambol, MD, FACS
|Senior Associate Dean for Clinical Affairs||
*Questions regarding contracting
|Esteban Santana, III M.Div.||Manager, Managed Care Operations||
|Kimberly Pasley||Management Assistant||
|Maria Colón||Credentialing Specialist||
|Jamilah A. Muhammad, BS-HSM||Program Support Specialist||
|Mr. Kerry D. Strothers||Managed Care Coordinator (Credentialing)||
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