- Humana (Hartford, CT)
- …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... receives guidance where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical knowledge, communication… more
- CVS Health (Hartford, CT)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST and CST zones.… more
- Humana (Hartford, CT)
- …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
- Zurich NA (Hartford, CT)
- …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
- Evolent (Hartford, CT)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies and ... the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...and regulations. * Practices and maintains the principles of utilization management and appeals management … more
- Baystate Health (Springfield, MA)
- …Health Center** The **ACO Nurse Care Manager i** s responsible for the management of care for a defined group of patients including complex care management , ... Nurse Care Manager, Community...management application is required and is vital. Care management program metrics including, emergency room utilization ,… 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
- 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, ... are most receptive including home, nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and… more
- Baystate Health (Springfield, MA)
- … driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... **Licensed Practical Nurse (LPN), Inpatient Medical Telemetry Unit** Baystate Health,...Excellence is looking for a medical inpatient Licensed Practical Nurse to join our team in Springfield, MA. A… more
- Sharecare (Hartford, CT)
- …total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also ... the participants and their Primary Care Provider according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised… more
- Baystate Health (Springfield, MA)
- …nurse driven change projects including activity/mobility tool, acuity-based assignments, capacity management workflow, and foley utilization . + The Manager is ... Hospital for Nursing Excellence is looking for a medical telemetry inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, RN means… more
- …leader in healthcare quality and safety, is looking for a** **Clinical Nurse Manager** **to join our** **Home Health** **team!** **Why choose Baystate Homecare?** ... the past few years. Home Health allows for 1:1 patient connections and flexible nurse schedules with limited weekends, which creates the space for not only work/life… more
- Eastern Connecticut Health Network (Vernon, CT)
- $8K SIGN ON BONUS Why consider applying to Visiting Nurse & Health Services of CT? Here are a few reasons: + Small territories and manageable caseloads and flexible ... degree program. + Possession of a current license to practice as a Registered Nurse in the State of Connecticut. EXPERIENCE: + One (1) year of recent… more
- Highmark Health (Hartford, CT)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Evolent (Hartford, CT)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
- Trinity Health (Springfield, MA)
- …BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in Connecticut. + **Certification** : BLS (AHA/ARC). Certification in Case ... Management (ACM, CCM) required within one year of employment...experience in an acute care facility or public health nurse setting. + Including an in-depth understanding of and… more
- Trinity Health (Hartford, CT)
- …Knowledge and experience with SAMSHA regulations, DPH, Joint Commission, Utilization management Detoxification requirements, Core measures, and psychiatric ... do** + The Clinical Coordinator RN assists in the management of unit personnel, the nursing unit environment, and...preferred + **Licensure** : Current licensure as a Registered Nurse RN in Connecticut ACLS and PALS preferred +… more
- Fresenius Medical Center (Springfield, MA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- United Therapeutics (Hartford, CT)
- …for which transplant is not currently an option. Who you are You are experienced nurse and an expert in all things PAH. You love providing mentorship, coaching and ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...+ Plan, collaborate, create and produce the yearly Clinical Nurse Summit meeting for HCPS across the United States… more
- Molina Healthcare (Springfield, MA)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... including 3 or more years in one or more of the following areas: utilization management , case management , care transition and/or disease management… more