- Humana (Hartford, CT)
- …a part of our caring community and help us put health first** The Weekend 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
- 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
- Lincoln Financial (Hartford, CT)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- CVS Health (Hartford, CT)
- …+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- CVS Health (Hartford, CT)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… 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
- Molina Healthcare (Middletown, CT)
- **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, ... are most receptive including home, nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and… 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
- Hartford HealthCare (Hartford, CT)
- …identity, national origin, and veteran or disability status./ **Job:** ** Management * **Organization:** **Hartford Hospital* **Title:** *Administrative Nurse ... to us. *Job Summary:* . The Patient Care Administrative Nurse Supervisor is an experienced Registered Nurse ...delivery of direct and indirect patient care via the utilization of the Nursing Process and creates a positive… 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)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
- Highmark Health (Hartford, CT)
- …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... Documents, processes and routes requests for services to the nurse reviewer and other departments based on documentation procedures,...and management . + Route Cases Based on Established Guidelines. +… 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
- Amgen (New Haven, CT)
- …playing a key role in establishing product demand and delivering comprehensive account management within a designated territory. You will serve a central point of ... to support optimal patient care. As a SAM, you will drive product utilization while identifying and addressing the unique needs of each account. This includes… 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
- 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
- ZOLL Medical Corporation (New Haven, CT)
- …patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed ... patients at risk of sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia- management -system/) (Heart Failure Management system) is a… more
- Fortive Corporation (Hartford, CT)
- …and local Integrated Delivery Networks (IDN), including the following: Supply Chain, Nurse Managers, Risk Management , and Sterile Processing, Materials ... positive Customer experiences. + Drive market share through existing customer utilization assessments and contending for new footprint expansion while developing… more
- Trinity Health (Hartford, CT)
- …Aides and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and patient satisfaction. ... active involvement in quality improvement activities. + Provides ongoing care management oversight/activities to assigned patients to achieve high quality care,… more