- Humana (Hartford, CT)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
- Baystate Health (Springfield, MA)
- …a Magnet Hospital for Nursing Excellence is looking for a medical telemetry inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... Degree (Required) **Certifications:** Basic Life Support - American Heart Association, Registered Nurse - State of Massachusetts **Equal Employment Opportunity… more
- Baystate Health (Springfield, MA)
- …Magnet Hospital for Nursing Excellence is looking for a new graduate medical inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... Degree (Required) **Certifications:** Basic Life Support - American Heart Association, Registered Nurse - State of Massachusetts **Equal Employment Opportunity… more
- The Cigna Group (Bloomfield, CT)
- …duties as assigned. **Qualifications** + Education: Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) + 3-5 years' experience in Medicare Advantage ... Requirements include, but not limited to:** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare Part C + Ability to… more
- Hartford HealthCare (Torrington, CT)
- …Master's degree in Social Work * Active LCSW required * Two years with behavioral health utilization review As a Hartford HealthCare entity, Charlotte Hungerford ... comfortable patient environment. *Job Summary* Under the Direction of the Inpatient Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization… more
- The Cigna Group (Bloomfield, CT)
- …history of effective case load management .** **Minimum Requirements:** **Active** **Unrestricted Registered ** ** Nurse ( RN ) license in state or territory ... ** Nurse Case Management Lead Analyst -Remote...and assigning to a client based CM for further management when appropriate.** **Must be skilled in utilization… more
- Hartford HealthCare (Newington, CT)
- …3. _Fiscal Management :_ o Evaluates all throughput and bed resource utilization for potential implementation of cost effective changes. o Reviews urgency of ... balance. Every moment matters. And this is */your moment./* **Job:** ** Management * **Organization:** **Hartford HealthCare Corp.* **Title:** * Behavioral Health… more
- Baystate Health (Springfield, MA)
- …Basic Life Support - American Heart Association, Driver License - Other, Registered Nurse - State of Massachusetts **Equal Employment Opportunity Employer** ... Nurse Care Manager i** s responsible for the management of care for a defined group of patients...management application is required and is vital. Care management program metrics including, emergency room utilization ,… more
- Masonicare (Wallingford, CT)
- …as related to Hospice services. Certificates, Licenses, Registrations: Current Connecticut Registered Nurse License. Maintains current Drivers' License and auto ... RN Hospice Clinical Manager Job Location: Wallingford Center,...and reviews work. Participates in and provides coordination and management of all professional services rendered to clients and… more
- Hartford HealthCare (Meriden, CT)
- …including customer service representatives, admission specialist in the Call Center, Utilization Management for residential services. The Director ensures high ... monitor staff progress throughout the year utilizing effective performance management strategies. 2. Drives positive customer service relationships by identifying… more
- The Cigna Group (Bloomfield, CT)
- … Behavioral Telephonic Consultation + Confide Services Assessment + Brief Case Management + Utilization Management **Duties and Responsibilities:** + ... will help customers navigate the mental health system, including utilization of benefits and accessing direct care services. As...the state of employment (LADC, LPC, LMHC, LCSW, LMFT, RN or LP). + 5 plus years post licensure… more
- The Cigna Group (Bloomfield, CT)
- …and reimbursement for multiple Therapeutic Resource Centers. **QUALIFICATIONS** + Active, unencumbered Registered Nurse ( RN ) license in Pennsylvania + High ... Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for...providers, members and patient client advocates within the Prior Authorization/ Utilization Management department. Identify and track trends… more
- Baystate Health (Springfield, MA)
- …Basic Life Support - American Heart Association, Driver License - Other, Registered Nurse - State of Massachusetts **Equal Employment Opportunity Employer** ... care management application is required and is vital. Care management program metrics including, emergency room utilization , and hospital… more
- CVS Health (Hartford, CT)
- …expense reimbursement policy. Preferred Qualifications : Oklahoma residency preferred Oklahoma-licensed registered nurse preferred OR be certified as a Certified ... a variety of external and internal audiences including senior management . Required Qualifications : * 5 to 7 years'...(CHCQM) by the American Board of Quality Assurance and Utilization Review Providers prior to employment. A minimum of… more
- Moses/Weitzman Health System (New Britain, CT)
- …professional organizations. + Minimum of one year prior experience as an advanced practice registered nurse + As a condition of employment, CHC requires current ... collaboratively within an inter-disciplinary team including members of the medical staff, behavioral health staff, and other CHC disciplines or sites. + Collaborates… more
- The Cigna Group (Bloomfield, CT)
- …and specialist appointment scheduling. . Provide clinical assessments, health education, and utilization management to customers, as needed. . Initiate contact ... team. . Other duties as assigned. **Qualifications** : . Active and Unencumbered Compact Registered Nurse licensure required . A minimum of three or more years… more
- The Cigna Group (Bloomfield, CT)
- …and specialist appointment scheduling. + Provide clinical assessments, health education, and utilization management to customers, as needed. + Initiate contact ... issues to the appropriate team. + Other duties as assigned. **Qualifications** : + Registered Nurse with 1-2 years related experience and/or training in Case … 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 ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Hartford HealthCare (Hartford, CT)
- …service, health insurance, billing/coding requirements, and EMR functionality and utilization . Supervises the administrative and clinical staff and practice ... first contact for prospective patients, collaboration with our marketing team, management of incoming referrals and completing registration for education sessions… 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 , Inpatient Medical Unit** **Sign On Bonus Eligible!** Baystate Health, a nationally recognized leader in healthcare quality and safety,… more