- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… 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
- Sharecare (Hartford, CT)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Hartford, CT)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour)...+ + + + Introduction Are you a skilled Registered Nurse ( RN )? Join our team ... and Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) !… more
- The Cigna Group (Bloomfield, CT)
- …and reimbursement for multiple Therapeutic Resource Centers. **QUALIFICATIONS** + Active, unencumbered Registered Nurse ( RN ) license in state of residency. ... Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for...is preferred in prior authorization or utilization review and appeals + Case Management experience… more
- Hartford HealthCare (Norwich, CT)
- …Physicians and APP providers, nurses, PT, OT, Imaging, cardiology, neurology, psychiatry, case management and utilization review . The APP will be the ... the patients, caregivers and families, as well as case management and utilization review to...be licensed, as a Physician Assistant / Advanced Practice Registered Nurse (APRN) in the state of… more
- Baystate Health (Springfield, MA)
- …- American Heart AssociationAmerican Heart Association, Driver License - OtherOther, Registered Nurse - State of MassachusettsState of Massachusetts **Equal ... 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
- Baystate Health (Springfield, MA)
- The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of ... and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers… more
- Masonicare (Cromwell, CT)
- …as related to Hospice services. Certificates, Licenses, Registrations: Current Connecticut Registered Nurse License. Maintains current Drivers' License and auto ... RN Hospice Clinical Manager (Weekend Schedule) Job Location:...on-call schedules, plans and organizes daily assignments including the review and assignment of new patient referrals. + Supervises… 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
- University of Connecticut (UConn) (Storrs, CT)
- …- Mental Health (MH), is seeking applicants for a Psychiatric Advanced Practice Registered Nurse (APRN) for the position of Director, Psychiatric Medication ... mental health and wellness concerns for student populations. The Advanced Practice Registered Nurse maintains an independent clinical practice, performing acts… more
- Hartford HealthCare (Wethersfield, CT)
- …in the current, rapidly changing medical environment. *_Position Summary:_* The Clinical Resource Management Nurse is an integral part of the Care Management ... on their clinical needs incorporating the judgment of their provider. The Clinical Resource Management Nurse is able to work autonomously and swiftly, managing a… more
- Baystate Health (Palmer, MA)
- …PATIENTS. DIVERSE LOCATIONS. **Education:** Bachelor of Science (Required) **Certifications:** Case Management Certification - Other, Registered Nurse - ... Team and documents findings of the Interdisciplinary Care Plan. Collaborates with the Utilization Management Coordinator and other members of the healthcare team… more