• Utilization Management

    Humana (Hartford, CT)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in… more
    Humana (11/12/25)
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  • Clinical Denials Prevention & Appeals

    Nuvance Health (Danbury, CT)
    …in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum ... 12am- 830am* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are...of the interdisciplinary care team Current working knowledge of utilization management , performance improvement and managed care… more
    Nuvance Health (09/25/25)
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  • AVP Care Coordination

    Nuvance Health (Danbury, CT)
    …for providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff ... *System Care Coordination Leader* will be responsible for leading a team encompassing utilization review and denials/ appeals specialists and will need to foster… more
    Nuvance Health (09/10/25)
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