- Trinity Health (Hartford, CT)
- …efficiently to control costs. **What you will do:** + As a ** Utilization Management Registered Nurse RN ** you will conduct prospective, concurrent ... and the Smilow Cancer Hospital. **Keywords: Case Management ; Case Manager; Registered Nurse ; RN ; BSN; Connecticut** **Our Commitment to Diversity… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Humana (Hartford, CT)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with no… more
- CVS Health (Hartford, CT)
- …skills, both verbal and written Required Qualifications - 3+ years of experience as a Registered Nurse - Must possess 1+ years of clinical experience in acute or ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...acute setting - Must have active current and unrestricted RN licensure in state of residence - Must be… more
- Trinity Health (Waterbury, CT)
- …in addition to a Bachelor's in Nursing. + **Licensure** : Current licensure as a registered nurse ( RN ) in Connecticut. + **Experience** : Five or more ... DRG's/ICD9/10, medical necessity criteria, JCAHO, CMS requirements for discharge planning, utilization management , and levels of care in continuum. **Position… more
- Sharecare, Inc. (Hartford, CT)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... with the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations… more
- Marriott (Hartford, CT)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... that may include multiple states. + Conducts first level utilization review per jurisdictional requirements. + Coordinates...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- Trinity Health (Hartford, CT)
- …of significant challenge or difficulty in their lives. **keywords: Behavioral Health; Psychiatric; Registered Nurse ; RN ; Per Diem; Connecticut; ... BSN preferred + **Licensure** : Current licensure as a Registered Nurse RN in Connecticut...Knowledge and experience with SAMSHA regulations, DPH, Joint Commission, Utilization management Detoxification requirements, Core measures, and… more
- The Cigna Group (Bloomfield, CT)
- …term acute care, skilled nursing and inpatient rehab facilities, home health care, care management , and utilization review. The Nurse is responsible for the ... The Registered Nurse will perform clinical and...care experience + 2 - 4 years' experience in utilization management required. + Home health, SNF,...a minimum of 18 days of paid time off per year and paid holidays. For more details on… more
- The Cigna Group (Bloomfield, CT)
- …as needed. + Additional duties as assigned. **Qualifications** + Education: Licensed Practical Nurse or Registered Nurse + 3-5 years' experience in ... limited to:** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare...a minimum of 18 days of paid time off per year and paid holidays. For more details on… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …license for clinical social work, marital and family therapist, professional counselor, registered nurse or psychologist. Department of Mental Health and ... license for clinical social work, marital and family therapist, professional counselor, registered nurse , psychologist or alcohol and drug counselor. Conclusion… more
- Humana (Hartford, CT)
- …projects. **Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin or have a compact license. ... community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the… more
- CenterWell (Hartford, CT)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... criteria for admission to service, case assignments, and case management . + Represent the pharmacy in a professional and...Graduate of an accredited school of nursing and current RN state license in good standing OR a graduate… more