• Mgr Utilization Review RN

    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
    Baylor Scott & White Health (01/23/25)
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  • Dialysis Clinical Manager Registered

    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
    Fresenius Medical Center (12/31/24)
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  • Care Manager RN - Weekends (Remote)

    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
    Highmark Health (01/07/25)
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  • Utilization Management Nurse

    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
    CVS Health (01/24/25)
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  • RN , Hospital Case Manager -Per Diem

    Baystate Health (Springfield, MA)
    **Hospital Case Manager** Per Diem The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial ... and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers… more
    Baystate Health (01/22/25)
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  • RN Hospice Clinical Manager (Weekend…

    Masonicare (Colchester, 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
    Masonicare (01/15/25)
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  • RN Clinical Consultant, Claims Shared…

    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
    Guardian Life (12/20/24)
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  • Director, Psychiatric Medication Services - APRN

    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
    University of Connecticut (UConn) (12/31/24)
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