- Moses/Weitzman Health System (Meriden, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and organizational… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- 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 ... members of the interdisciplinary care team * Current working knowledge of utilization management , performance improvement and managed care reimbursement. Working… more
- Elevance Health (Wallingford, CT)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... shift between 8 AM and 6 PM Eastern. The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Sharecare (Hartford, CT)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Elevance Health (Wallingford, CT)
- ** Nurse Reviewer I** A proud member of the...hospital setting or minimum of 1 year of prior utilization management , medical management and/or ... state(s) required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… 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 ... the context of the framework for professional nursing practice, the Community Care Nurse Navigator is a registered nurse experienced in patient throughput,… 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, ... appropriate practices, standards, protocols and guidelines. This position reports to a Nurse Manager Manager. **Job Responsibilities:** * Functions as a member of an… more
- AccentCare, Inc. (Middlebury, CT)
- Overview Admissions Registered Nurse / RN, Hospice Location: Middlebury, CT Position: Admissions Registered Nurse / RN, Hospice Position Type: Part Time ... GIP admissions/visits Find Your Passion and Purpose as a Hospice Admissions Registered Nurse Salary: $43 - $50 / hourSchedule: Every Saturday and Sunday 8am -… more
- Humana (Hartford, CT)
- …degree in a related field + Health Plan experience + Previous experience in utilization management , discharge planning and/or home health or rehab + Bilingual is ... us put health first** The NICU Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates...and wellbeing of members. The NICU Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require… 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 ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Hartford HealthCare (New Britain, CT)
- …balance. Every moment matters. And this is *your moment*. **Job:** ** Management * **Organization:** **New Britain General* **Title:** *Assistant Nurse Manager ... end of life. * Job Summary* The Assistant Nursing manager is a Registered Nurse (RN) who has responsibility for the supervision of patient care, clinical personnel,… more
- Nuvance Health (Sharon, CT)
- …the Wound Care Center. These include, but are not limited to , utilization of skills in organization, planning, implementing, evaluating, and providing care through ... of hospital and nursing standards. Duties and Responsibilities: 1. Provides case management to a group of patients providing specific assessments according to… more
- Nuvance Health (Danbury, CT)
- *Description* Summary: Coordinates and performs utilization review and patient medical record audits according to State & Federal licensing regulations and Joint ... plans to improve clinical documentation. Responsibilities: 1. Coordinates and performs utilization review and patient medical record audits according to State &… more
- Nuvance Health (Danbury, CT)
- …patient-centric vision and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social ... related field preferred * Current licensure as a registered nurse (RN) * Minimum of 5 years of clinical...of 5 years of progressive leadership experience in case management or utilization review * Proven leadership… more
- Nuvance Health (Danbury, CT)
- …this a truly special place to work. Summary: The Director of Case Management provides strategic leadership and operational oversight for the hospital case ... management program. This role is responsible for ensuring effective...Work or a related field required. Current CT Registered Nurse (RN) license. Minimum of 5 years of progressive… more
- Hartford HealthCare (Torrington, CT)
- …convenient, safe and comfortable patient environment. *_POSITION SUMMARY/PURPOSE_* Care Management is a collaborative practice model including patients, nurses, ... physicians, healthcare team members,, caregivers and the community. The Case Management process encompasses communication and facilitates care along a continuum… more
- Amgen (New Haven, CT)
- …playing a key role in establishing product demand and delivering comprehensive account management within a designated territory. You will serve a central point of ... to support optimal patient care. As a SAM, you will drive product utilization while identifying and addressing the unique needs of each account. This includes… more
- Sharecare (Hartford, CT)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- ZOLL Medical Corporation (New Haven, CT)
- …patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed ... patients at risk of sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia- management -system/) (Heart Failure Management system) is a… more
