- Moses/Weitzman Health System (Meriden, CT)
- …component meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and ... licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or… more
- CVS Health (Hartford, CT)
- …all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Hartford, CT)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Hartford, CT)
- …(UM) Nurse Consultant . As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... clinical records. **Key Responsibilities of the UM Nurse Consultant ** (Includes but is not limited to) + Reviews...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- IQVIA (Oxford, CT)
- …position, you must reside in the same country where the job is located._ ** Consultant - Commercial Solutions & Insights Hub (CSIH), Analytics Pillar** IQVIA CSIH is ... trends in complex data sets. + Provide Business Consulting and Project Management : The candidate will apply consulting methodologies to deliver engagements, create… more
- Highmark Health (Hartford, CT)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- CVS Health (Hartford, CT)
- …every day. **Position Summary** Responsible for the review and resolution of clinical appeals. Reviews documentation and interprets data obtained from clinical ... requirements for member and provider issues. Independently coordinates the clinical resolution with internal/external clinician support as required. This position… more
- Nuvance Health (Danbury, CT)
- …of hospitalization, LOC status, LOS management , continued stay decisions, clinical review of patients, utilization review activities, resource utilization ... , quality, and administrative facets of the healthcare industry. * Strong clinical acumen; Knowledge of Care Management / Utilization Review principles,… more
- The Cigna Group (Bloomfield, CT)
- …and external customers. He/she will serve as a clinical educator and consultant to utilization management , case management , network, contracting, ... of position** : A Medical Principal performs medical review and case management activities. The physician provides clinical insight to the organization… 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 ... by outstanding clinical diagnostics laboratories, which provide state-of-the-art techniques for rapid diagnosis of infectious diseases. Our staff of providers,… more
- The Cigna Group (Bloomfield, CT)
- **Role Summary:** As part of Cigna Pharmacy Management , the Pharmacy Account Executive (PAE) serves as the primary pharmacy benefits subject matter expert supporting ... responsible for developing and maintaining relationships with internal stakeholders, clients, brokers/ consultant by supporting the medical sales teams with the Cigna… more
- Hartford HealthCare (Hartford, CT)
- …ClinicNurse Navigator provides skilled nursing care to patients in a variety of clinical settings. Scope of responsibility is characterized by use of nursing process ... The goals include reducing all-cause readmissions, and inappropriate ED utilization , improving care coordination for patients during the transitional care… more
