- Baylor Scott & White Health (Hartford, CT)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Fresenius Medical Center (Bristol, CT)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Highmark Health (Hartford, CT)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- CVS Health (Hartford, CT)
- …Qualifications** + Must reside within the Eastern or Central time zone + Utilization management is a 24/7 operation. Work schedules will include weekends ... + 3+ years of clinical hospital experience as a Registered Nurse in Medical/Surgical, Emergency room, Critical...and Excel **Preferred Qualifications** + Managed Care experience + Utilization review experience + Experience working with… more
- Guardian Life (Hartford, CT)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more