- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in… more
- Sharecare (Hartford, CT)
- …open enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited ... 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management ...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Eastern Connecticut Health Network (Manchester, CT)
- …in a medical surgical acute care setting + Additional experience in case management , home care, and utilization review/ management is preferred. COMPETENCIES ... hospital as needed. Reports to the Manager of Care Management . EDUCATION/CERTIFICATION + Graduate of an accredited school of...+ Must have a current license as a Registered Nurse in the State of Connecticut . + Professional… more