- Cognizant (Hartford, CT)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Hartford, CT)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Hartford, CT)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team.… more
- CVS Health (Hartford, CT)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Commonwealth Care Alliance (Springfield, MA)
- …in primary care or care management, including: + 5+ years' experience as Registered Nurse in a high touch clinical environment or home care + AND + 2+ ... management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral...and social needs. The RN uses evidenced-based care approaches, clinical skills, education, and training to influence the … more
- Hartford HealthCare (Mansfield Center, CT)
- …HealthCare at Home* **Title:** *Quality Assurance Performance Improvement Coordinator (RN, Registered Nurse , QA, PI) - HomeCare * **Location:** ... using research, innovation and evidence-based practices. We offer our Graduate Registered Nurses clinical instruction and additional learning opportunities as… more
- CVS Health (Hartford, CT)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Evolent (Hartford, CT)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... 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… more
- CVS Health (Hartford, CT)
- …performance. **Education** Bachelor's degree preferred/specialized training/relevant professional qualification. Registered Nurse (RN) required. **Prior Relevant ... utilization reviews and assessments, applying evidence-based criteria and clinical knowledge to evaluate the medical necessity and appropriateness of requested… more
- Sharecare (Hartford, CT)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Hartford HealthCare (Hartford, CT)
- …within the context of the framework for professional nursing practice, the Community Care Nurse Navigator is a registered nurse experienced in patient ... of infectious diseases. The service is supported by outstanding clinical diagnostics laboratories, which provide state-of-the-art techniques for rapid diagnosis… more
- Molina Healthcare (Rockville, CT)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary... Practitioner will be required to work primarily in non- clinical settings and provide medical care to all levels… more
- Molina Healthcare (Rockville, CT)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- Hartford HealthCare (Hartford, CT)
- …the context of the framework for professional nursing practice, the Cystic Fibrosis Clinic Nurse Navigator is a registered nurse experienced in patient ... 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
- Baystate Health (Springfield, MA)
- …- American Heart AssociationAmerican Heart Association, Driver License - OtherOther, Registered Nurse - State of MassachusettsState of Massachusetts **Equal ... - Maximum $87,859.00 - $100,984.00 - $119,412.00 **RN, ACO Nurse Care Manager, Community Health Center** The **ACO ...their care by acting as their advocate regarding their clinical status and treatment options. + Promotes quality and… more
- Eastern Connecticut Health Network (Vernon, CT)
- …or baccalaureate degree program. + Possession of a current license to practice as a Registered Nurse in the State of Connecticut. EXPERIENCE: + One (1) year of ... identifying patient-related problems and recommending solutions. + Skill in documentation in clinical records and use of Electronic Medical Record. + Skill in… more
- Fresenius Medical Center (East Hartford, CT)
- …related field preferred or an equivalent combination of education and experience + Registered Nurse required + Certification in Nephrology Nursing or quality ... and performance improvement activities which positively influence the assigned dialysis clinics clinical quality outcomes. The scope of the clinical quality… more
- Hartford HealthCare (Hartford, CT)
- …Enfield, Farmington, West Hartford and Avon offices. Bachelor's Degree required . CT- Registered Nurse (RN) license- preferred * Minimum of 2 years ... specialties. The primary responsibility of the Metabolic and Bariatric Surgical/Medical Clinical Reviewer (MBSCR) is to ensure the accurate and timely collection,… more
- Baystate Health (Springfield, MA)
- …to this role. **Education:** Bachelors Degree in Nursing (Required) **Certifications:** Registered Nurse - State of MassachusettsState of Massachusetts **Equal ... facilitation of accurate patient placement into the health system based on clinical relevance, with integration of care management skills to support organizational… more
- Insight Global (Springfield, MA)
- …- Excellent communication - Master's degree preferred - CMRP preferred - Current Registered Nurse License - Lawson and/or WorkDay ERP experience preferred ... coordinating activities. Activities include, but are not limited to, standardization/ utilization projects and Network-wide new product/technology assessment within the… more