- Baystate Health (Springfield, MA)
- **_LPN Care Manager , ACO Behavioral Health & Transitions of Care Team_** is responsible for the management of care for a defined group of patients ... care management application is required and is vital. Care management program metrics including, emergency room utilization...so much more! Under the direction of the RN Care Manager , the LPN Care … more
- Baystate Health (Springfield, MA)
- **RN, Pediatric Nurse Care Manager - ACO** The **ACO Pediatric Nurse Care Manager i** s responsible for the management of care for a defined group of ... room, or from a skilled nursing facility. Responsible to review the discharge summaries, follow up on testing that...care management application is required and is vital. Care management program metrics including, emergency room utilization… more
- National Health Care Associates (Wethersfield, CT)
- …both + Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable + Experience/knowledge of ... experience preferred **What You'll Do:** As a Regional Case Manager , you will play a vital role in advocating..._Review clinical documentation for medical necessity and level of care appropriateness_ + Collaborate with treatment team to create… more
- CVS Health (Hartford, CT)
- …Word, Excel) **Preferred Qualifications** + Crisis Intervention skills + Managed care / utilization management experience + Case Management and discharge planning ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Cardinal Health (Hartford, CT)
- …(TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy ... therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient support services in… more
- GAF (Springfield, MA)
- …this roof, we protect what matters most. **Team Summary** The Maintenance Excellence Manager is a key member of the Corporate Reliability & Maintenance team and ... to execute PM and PdM programs developed for asset care programs. This is a remote-based position with travel...to optimize GAF craft labor efficiencies, as well as utilization of outside contractors.. + Supports development of Asset… more
- Stanley Black and Decker (New Britain, CT)
- …Oversight** + Review production schedules and plans to optimize resource utilization , minimize lead times, and meet customer demands + Implement best practices ... Supply Chain Production Planning Manager NA-Outdoor **Come make the world and accelerate...People with a relentless pursuit of excellence. People who care about making things better For Those Who Make… more
- Eastern Connecticut Health Network (Vernon, CT)
- …practice through collegial support and interactions. Under the direction of the Clinical Manager , is responsible for oversight of patient care via support and ... provided by clinicians through conferences, home visits and record review . Also has responsibility for the wound care...field staff to ensure timely and appropriate delivery of care . + Makes recommendations to Clinical Manager … more
- Baystate Health (Springfield, MA)
- …Advanced Practice Nurse, Physician Assistant, Occupational Therapist, Utilization Review Specialist, Mental Health Counselor, Patient Care Technician and ... the direction of the Director of Behavioral Health, Nurse Manager or Program Supervisor (as noted above), the Behavioral...groups as assigned. **6)** May collaborate as assigned with utilization review specialist to obtain necessary insurance… more
- Molina Healthcare (Farmington, CT)
- …Experience + 3-5 years of experience in case management, disease management or utilization management in managed care , medical or behavioral health settings. + ... Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health… more
- Hartford HealthCare (Mansfield Center, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and chemical dependency services. Through our multi-site network of care , we constantly strive to meet its mission in...oversight of daily operations in the absence of Program Manager . Key responsibilities of Lead Behavioral Health Clinician: *… more
- Cardinal Health (Hartford, CT)
- …company connecting patients, providers, payers, pharmacists and manufacturers for integrated care coordination and better patient management. Backed by nearly 100 ... + Support/recommend reporting, query and analysis tools ensuring efficient SAP/database utilization + Diagnosis of problems and resolution for SAP systems +… more
- Travelers Insurance Company (Hartford, CT)
- **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our ... teams to drive security best practices, enforce policy requirements, consult on service utilization , and help build better solutions overall. What Will You Do? .… more
- Prime Therapeutics (Hartford, CT)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations, etc); compile ... of interest or other cyclical compliance processes, or implementing a regular review cadence for standard operating procedures (SOP) and policies + Research and… more
- CenterWell (Hartford, CT)
- …by accessing and understanding formulary restrictions, plan limitations, drug utilization review overrides, requesting and completing prior authorization, ... good practices within the value-based model. + Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations.… more
- Sharecare (Hartford, CT)
- …goals and objectives of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and ... individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com… more
- CVS Health (West Hartford, CT)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... of continuous improvement, with the goal of changing health care for the better. **Position Summary:** At CVS Health,...+ Any additional tasks as directed by Supervisor or Manager **Preferred Qualifications:** + 1+ years of related work… more
- University of Massachusetts Amherst (Amherst, MA)
- …communications; administers procedures and training for new users; ensures proper utilization of the TMA system. Essential Functions + Determines and assigns ... priorities for work orders for Zone with IMFs and/or Manager using shift log data, new incoming request and...+ Monitors and manages pending, billable and all hazard review , finished work request buckets in TMA. + Monitors… more
- IQVIA (Springfield, MA)
- …Multiple Sclerosis. Also provides specialized education and training to home health care agencies, physicians, nursing and office staff within a defined geographic ... guidelines + When requested by National Director, assist with the development and review of educational material to be utilized by professional and lay customers +… more