- PharmaCord (Hartford, CT)
- …experience with relevant disease state experience preferred. Nurseline triage, Call Center Utilization Management , Call Center Case Management , a plus. ... collaborating to share ideas, support, and resources. As a Nurse Advocate you are responsible for contact with program...Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are… more
- Moses/Weitzman Health System (Hartford, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and organizational… more
- Commonwealth Care Alliance (Springfield, MA)
- …Intensive Care (CIC) programing is responsible for providing care delivery and care management to a specific panel of high risk and complex people. This panel ... with significant medical, behavioral, and social complexities that require intensive care management and care delivery. Within the CIC Program, the Community Health… more
- Commonwealth Care Alliance (Springfield, MA)
- …Intensive Care (CIC) programing is responsible for providing care delivery and care management to a specific panel of high risk and complex people. This panel ... with significant medical, behavioral, and social complexities that require intensive care management and care delivery. Within the CIC Program, The Senior Clinician,… more
- Humana (Hartford, CT)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Hartford, CT)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Lincoln Financial (Hartford, CT)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- CVS Health (Hartford, CT)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Elevance Health (Wallingford, CT)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- Sharecare (Hartford, CT)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- CVS Health (Hartford, CT)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Commonwealth Care Alliance (Springfield, MA)
- …influence the clinical outcomes of assigned patients by impacting acute care utilization , ensuring optimal treatment for chronic disease management , and closing ... in primary care or care management , including: + 5+ years' experience as Registered Nurse in a high touch clinical environment or home care + AND + 2+ years… more
- Baystate Health (Springfield, MA)
- …Health Center** The **ACO Nurse Care Manager i** s responsible for the management of care for a defined group of patients including complex care management , ... Nurse Care Manager, Community...management application is required and is vital. Care management program metrics including, emergency room utilization ,… more
- Hartford HealthCare (Hartford, CT)
- …Diseases provides inpatient and outpatient consultation regarding the diagnosis and management of all types of infectious diseases. The service is supported ... the context of the framework for professional nursing practice, the Community Care Nurse Navigator is a registered nurse experienced in patient throughput,… more
- Molina Healthcare (Rockville, CT)
- **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, ... are most receptive including home, nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and… more
- Hartford HealthCare (Hartford, CT)
- …context of the framework for professional nursing practice, the Cystic Fibrosis Clinic Nurse Navigator is a registered nurse experienced in patient throughput, ... appropriate practices, standards, protocols and guidelines. This position reports to a Nurse Manager Manager. **Job Responsibilities:** * Functions as a member of an… more
- Baystate Health (Springfield, MA)
- … driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... **Licensed Practical Nurse (LPN), Inpatient Medical Telemetry Unit** Baystate Health,...Excellence is looking for a medical inpatient Licensed Practical Nurse to join our team in Springfield, MA. A… more
- Baystate Health (Springfield, MA)
- … driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... Hospital for Nursing Excellence is looking for a medical inpatient Licensed Practical Nurse to join our team in Springfield, MA. **Our medical unit offers… more
- Baystate Health (Springfield, MA)
- … driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... Nursing Excellence is looking for a New Graduate Registered Nurse to join our team in Springfield, MA. At...Support - American Heart AssociationAmerican Heart Association, Certified Registered Nurse - OtherOther, Registered Nurse - State… more
- Evolent (Hartford, CT)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
