- Moses/Weitzman Health System (Hartford, 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)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Hartford, CT)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- CVS Health (Hartford, CT)
- …+ Human Resource and/or Supervisory experience. + Case management , Utilization Review, or Utilization Management background preferred. **Education** ... Friday, 11:00 am to 8:00 pm Eastern Time.** The Consultant provides management consultation to corporate clients...clinical assessments and triage into care. Performs case management across scope of all types of management… 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
- 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
- Elevance Health (Wallingford, CT)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May...an entire clinical program and/or independently performs clinical reviews. + Typically has program management … more
- Elevance Health (Wallingford, CT)
- …be responsible for an entire clinical program and/or independently performs clinical reviews. + Typically has program management responsibilities including ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… 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
