- PharmaCord (Danbury, CT)
- …Utilization Management , Call Center Case Management , a plus. Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree ... independently while collaborating to share ideas, support, and resources. As a Nurse Advocate you are responsible for contact with program patients and assessing… more
- 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)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Cognizant (Hartford, CT)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... 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 … 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 ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… 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)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Evolent (Hartford, CT)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by… more
- Sharecare (Hartford, CT)
- …helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… 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 ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- Hartford HealthCare (Mansfield Center, CT)
- …you are here. What our nurses love about HHCAH: * Automatic enrollment into the Nurse Residency Program for all graduate RNs with less than one year of experience. * ... innovation and evidence-based practices. We offer our Graduate Registered Nurses clinical instruction and additional learning opportunities as they complete the … 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...the framework for professional nursing practice, the Community Care Nurse Navigator is a registered nurse experienced… more
- Fairfield University (Fairfield, CT)
- **Job Description:** **Position Title: Advanced Practice Registered Nurse (APRN)** **Department: Student Health Center (SHC)** **9-month position (Academic Year)** ... **Description and Summary** The Advanced Practice Registered Nurse (APRN) will be responsible for providing primary care services to Fairfield University… more
- Highmark Health (Hartford, CT)
- …Degree in Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case/ utilization management and/or disease/condition management ... panel of members that range in health status/severity and clinical needs; and assesses health management needs...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Nuvance Health (Danbury, CT)
- …focusing on the delivery of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a safe and ... quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions… more
- Molina Healthcare (Rockville, CT)
- **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, ... including home, nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in... Practitioner will be required to work primarily in non- clinical settings and provide medical care to all levels… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work ... Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review/Quality Management experience + Experience working with MCG… more
- Molina Healthcare (Fairfield, CT)
- …primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing ... post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings… 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, ... skilled nursing care to patients in a variety of clinical settings. Scope of responsibility is characterized by use...standards, protocols and guidelines. This position reports to a Nurse Manager Manager. **Job Responsibilities:** * Functions as a… more
- Eastern Connecticut Health Network (Vernon, CT)
- …degree program. + Possession of a current license to practice as a Registered Nurse in the State of Connecticut. EXPERIENCE: + One (1) year of experience in ... identifying patient-related problems and recommending solutions. + Skill in documentation in clinical records and use of Electronic Medical Record. + Skill in… more
