- Highmark Health (Hartford, CT)
- …weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable… more
- The Cigna Group (Bloomfield, CT)
- …position is a licensed professional with a background in the insurance industry as a care manager in a behavioral healthcare role, or an individual who has ... mental health or chemical dependency counselor. As an Inpatient Care Manager at Cigna, you will use...utilization management, and attending all required trainings impacting utilization review and accreditation procedures. + Manage… more
- Baystate Health (Springfield, MA)
- …MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate ... **Hospital Case Manager ** Per Diem The Hospital Case Manager...+ Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
- Fresenius Medical Center (Bristol, CT)
- …maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line. ... regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal,… more
- Masonicare (Colchester, CT)
- …with administration). + Conducts clinical record reviews to assess the appropriateness of care plan, the utilization of services and to ensure complete ... RN Hospice Clinical Manager (Weekend Schedule) Job Location: Colchester, Connecticut RN...planning, organization, direction, evaluation and safe delivery of high-quality care to adult, geriatric, pediatric, and neonatal clients in… more
- Prime Therapeutics (Hartford, CT)
- …hoc reports are provided accurately and on time. + Supports the State Drug Utilization Review Boards and Pharmacy and Therapeutics (P&T) Committee. Potential pay ... every decision we make. **Job Posting Title** Pharmacist Account Manager - New York Remote **Job Description** + Leads...may vary by 8% depending on applicant location. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Evolent (Hartford, CT)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...for the culture. **What You'll Be Doing:** **Provider Engagement Manager - Oncology** We are looking for the next… more
- The Cigna Group (Bloomfield, CT)
- …to maintain clinical expertise. + The Case Manager interacts with Care Associates, benefit specialists, Cigna Coverage Review Department, Accredo Specialty ... individual's healthcare needs. Through communication and available resources, the Case Manager promotes care coordination, provider collaboration, quality case… more
- Hartford HealthCare (Middletown, CT)
- …all admissions related staff to expedite the clients' admissions process across Utilization Review , Nursing, Admission Specialists and other related departments. ... recovery programs. We offer a wide range of programs including Acute Care and Evaluation, Residential Addiction Treatment, Individual, Group & Family Therapy,… more
- Novo Nordisk (Springfield, MA)
- …Commercial team, you will have the opportunity to help people with obesity receive the care they deserve. The Novo Nordisk aspiration is to be a driving force in the ... providers, positioning Novo Nordisk as a leader in obesity care , understanding the local market and customer needs and...health. Internally, the OCS reports to the District Business Manager of the specific sales territory. The OCS also… 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
- 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
- Cardinal Health (Hartford, CT)
- …and effective coordination of Cardinal Health's pharmacy operations that service acute care hospitals, hospital retail customers, ambulatory care and alternate ... customized pharmacy program solutions that reduce costs and improve patient care quality for hospitals, health systems and other integrated healthcare providers… 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
- Hartford HealthCare (Hartford, CT)
- …Director, Stroke Coordinators, and multidisciplinary care team, including quality of care measures and review . . Collaboration with other departments caring ... disorders to Parkinson's disease, we offer an integrated approach to care that combines neurology, neuroscience, and neurosurgery. With state-of-the-art technology… more
- University of Connecticut (UConn) (Storrs, CT)
- …of Director, Psychiatric Medication (Services Student Clinical Mental Health Services Manager ). Provides clinical leadership for staff and faculty working with ... student populations, clinical and diagnostic assessment, psychotherapy, emergency care , consultation, and educational outreach to the University community regarding… more
- Northeast Family Services (West Springfield, MA)
- …quality assurance team, the Administrative QA Reporting Associate will support the QA Manager and assist in running, tracking, and compiling reports for the QA and ... MA, NH, or NY. Responsibilities: + Assist the QA Manager with running daily, weekly, and monthly reports. +...stakeholders for reporting clarification and accuracy + Help compile, review , and quality check reports + Provide a high… more
- Prime Therapeutics (Hartford, CT)
- …develop pricing in response to moderate to complex RFP's + Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing ... depth perception and ability to adjust focus **Reporting Structure** + Reports to Manager or Director in the Finance Department Potential pay for this position… more