- 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 the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Veterans Affairs, Veterans Health Administration (Leeds, MA)
- …after complete review of the EDRP application. Responsibilities This Registered Nurse (Acute Mental Health) position is located in the Nursing Services at the ... Leeds, MA location. This position is full time at 40 hours per week. Included but are not limited...customer service programs. The psychiatric Mental Health (MH) Registered Nurse provides and leads the provision of competent, evidence-based… more
- Trinity Health (Springfield, MA)
- …Nursing BSN degree preferred. + **Experience:** 3-5 years in Case Management, Utilization review , or similar experience preferred. Hospital or community-based ... program. BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS (AHA/ARC). CCM or ACM… more
- Trinity Health (Springfield, MA)
- …preferred. **Preferred Skills:** + **Experience:** 3-5 years in Case Management, Utilization review , or similar experience preferred. Hospital or community-based ... program. BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS (AHA/ARC). CCM or ACM… more
- The Cigna Group (Bloomfield, CT)
- …addressed properly and accurately; e) prepare case files for submission to Independent Review Entity, which also include writing required case summary on behalf of ... plan to support appeal resolution. This position is full-time ( 40 hours/week) with the scheduled core business hours generally...limited to:** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare Part C… more