- Moses/Weitzman Health System (Meriden, 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
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The 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
- CenterWell (Hartford, CT)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …LOCATION: 1000 Silver Street, Middletown, CT + UNIT: Addiction Services Division (ASD) Utilization Management + SCHEDULE: Full-Time, 37.5 Hours per Week, First ... Utilization Review Nurse (37.5 Hour) Office/On-Site...of the General Experience. PREFERRED QUALIFICATIONS + Experience with Utilization Review and Management in a healthcare… 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
- Veterans Affairs, Veterans Health Administration (West Haven, CT)
- Summary The Registered Nurse -Resource Pool Nurse position is located in Nursing Operations at the West Haven, CT. This position is intermittent. Responsibilities ... The Resource Pool Registered Nurse (RN) demonstrates proficiency in practice based on conscious...for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care.… 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
- 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
- AccentCare, Inc. (Middlebury, CT)
- Overview Admissions Registered Nurse / RN, Hospice Location: Middlebury, CT Position: Admissions Registered Nurse / RN, Hospice Position Type: Part Time ... GIP admissions/visits Find Your Passion and Purpose as a Hospice Admissions Registered Nurse Salary: $43 - $50 / hourSchedule: Every Saturday and Sunday 8am -… more
- Hartford HealthCare (New Britain, CT)
- …balance. Every moment matters. And this is *your moment*. **Job:** ** Management * **Organization:** **New Britain General* **Title:** *Assistant Nurse Manager ... end of life. * Job Summary* The Assistant Nursing manager is a Registered Nurse (RN) who has responsibility for the supervision of patient care, clinical personnel,… more
- Highmark Health (Hartford, CT)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Evolent (Hartford, CT)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- CVS Health (Hartford, CT)
- …**Preferred Qualifications** * Appeals Experience * Managed Care Experience * Utilization review experience * Proficiency with computer skills including navigating ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- Hartford HealthCare (Torrington, CT)
- …convenient, safe and comfortable patient environment. *_POSITION SUMMARY/PURPOSE_* Care Management is a collaborative practice model including patients, nurses, ... physicians, healthcare team members,, caregivers and the community. The Case Management process encompasses communication and facilitates care along a continuum… more
- Datavant (Hartford, CT)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- Sharecare (Hartford, CT)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Highmark Health (Hartford, CT)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Hartford HealthCare (Farmington, CT)
- …CDI subject matter expert guidance to CDS team, coding, physician leadership, quality management , utilization management , all providers, and others as ... now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the… more
- Hartford HealthCare (Meriden, CT)
- …required workload, forecasted units of service and programmatic changes. Assures appropriate fiscal management of COI program and the proper utilization of HHC's ... initiatives including operational excellence and efficiency, service delivery, growth management , and financial performance. Works collaboratively with the COI… more
