- Yale New Haven Health (Berlin, CT)
- …individuals and professionals, every day. Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans, ... Functions As A Preceptor To New Staff. Functions As A Charge Nurse . Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization ,… more
- 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
- 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 ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in XXX zones **Education**… more
- CVS Health (Hartford, CT)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CenterWell (Hartford, CT)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251119-5613FP-001 Location Middletown, CT Date Opened 12/11/2025 12:00:00 AM Salary ... Campus Hospital (https://portal.ct.gov/dcf/solnit-center/south) - is accepting applications for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) (REGULATORY) position,… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 251117-5612FP-001 Location New Haven, CT Date Opened 12/8/2025 12:00:00 AM Salary $78,480* - ... and Addiction Services ( DMHAS (http://portal.ct.gov/DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) ! In this… 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
- 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 ... framework for professional nursing practice, the Community Care Advanced Practice Nurse or Physician Assistant is experienced in patient throughput, preventing… more
- Evolent (Hartford, CT)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… 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
- Hartford HealthCare (Southington, CT)
- …in the following activities: Provides staff guidance in making clinical and case management decisions focused on clinical excellence for end of life care and symptom ... management . Directs staff in the Medicare Hospice Benefit guidelines...clinical software to identify opportunities for education, most appropriate utilization of services, oversee clinical progression of patients and… 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
- Humana (Hartford, CT)
- …Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review/Quality Management experience + Experience working with MCG ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals... 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments are varied and frequently require… more
- Eastern Connecticut Health Network (Manchester, CT)
- $8,000 SIGN ON BONUS! POSITION SUMMARY: Responsible for the management of more than one defined area of organized patient care services. Allocates available ... administrative leadership and expertise. Facilitates an atmosphere of participative management and the development of collegial relationships. Visible, accessible… more
- CenterWell (Hamden, CT)
- …driver's license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
- Highmark Health (Hartford, CT)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). + Delaware RN license must...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… 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
- Datavant (Hartford, CT)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- Highmark Health (Hartford, CT)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
