- Highmark Health (Hartford, CT)
- …Description :** **JOB SUMMARY** This job is responsible for working with HHO clinical departments in the areas of compliance and process improvement. Serves ... as a corporate resource regarding accreditation standards, clinical performance and continuous improvement...maintenance of Care Management policies and procedures to ensure accreditation and compliance with NCQA and DMMA… more
- Eastern Connecticut Health Network (Manchester, CT)
- …POSITION SUMMARY: Coordinates the activities of the Credentialing Program in compliance with state, federal and Joint Commission standards. Coordinates the ... requests and performs primary source verifications for appointment, reappointment, clinical privileges, and temporary privileges in accordance with medical staff… more
- Hartford HealthCare (Mansfield Center, CT)
- …health, residential treatment for court-involved teenage girls, geriatric services, clinical day treatment schools and chemical dependency services. Through our ... Technique and Trauma-informed yoga. *_Position Summary_* The Director will provide clinical and administrative leadership for Journey house, which include program… more
- CVS Health (Hartford, CT)
- …clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... and/or member's needs to ensure appropriate administration of benefits. + Applies clinical judgment to the incorporation of strategies designed to reduce risk… more
- CVS Health (Hartford, CT)
- …clients - Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... and/or member's needs to ensure appropriate administration of benefits - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors… more
- Humana (Hartford, CT)
- …to maximize each beneficiary's capacity for self-care, to cost-effectively achieve desired clinical outcomes and to enhance quality of medical care. The case manager ... of case management involvement. The case manager will serve as the primary coordinator and point of contact for the beneficiary for all activities within the… more