- Cognizant (Hartford, CT)
- …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical … more
- CVS Health (Hartford, CT)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in XXX zones **Education**… more
- Hartford HealthCare (Manchester, CT)
- …necessity. * Utilizes data to drive decisions related to utilization management for assigned patients, including fiscal and clinical data. * Responsible ... moment **Job:** **Care/Case Management * **Organization:** **Manchester Memorial Hospital* **Title:** * Clinical Resource Management Nurse (RN) - Case… more
- Baystate Health (Springfield, MA)
- …Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager** is a registered nurse ... for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other...Work Experience:** + BSN Strongly preferred + 3-5 years clinical Nursing experience + Hospital Case Management ,… more
- Evolent (Hartford, CT)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- CVS Health (Hartford, CT)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- Hartford HealthCare (Hartford, CT)
- …context of the framework for professional nursing practice, the Cystic Fibrosis Clinic Nurse Navigator is a registered nurse experienced in patient throughput, ... skilled nursing care to patients in a variety of clinical settings. Scope of responsibility is characterized by use...standards, protocols and guidelines. This position reports to a Nurse Manager Manager. **Job Responsibilities:** * Functions as a… more
- Hartford HealthCare (New Britain, CT)
- …balance. Every moment matters. And this is *your moment*. **Job:** ** Management * **Organization:** **New Britain General* **Title:** *Assistant Nurse Manager ... Job Summary* The Assistant Nursing manager is a Registered Nurse (RN) who has responsibility for the supervision of...who has responsibility for the supervision of patient care, clinical personnel, and unit operations. This position supervises a… more
- Evolent (Hartford, CT)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... accomplishments. **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Hartford HealthCare (Farmington, CT)
- …CDI subject matter expert guidance to CDS team, coding, physician leadership, quality management , utilization management , all providers, and others as ... now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the… more
- Hartford HealthCare (Farmington, CT)
- …department of Clinical Informatics leverages our uniquely equipped Physician and Nurse Informaticists to promote and improve the utilization of innovative ... new technologies and processes. . Develop and implement change management strategies to guide the clinical teams through the transition to new tools and systems.… more
- Fresenius Medical Center (East Hartford, CT)
- …(QAPI) documentation and attends QAPI meetings at a frequency determined by Clinical Quality leadership. Collaborates with facility management staff to evaluate ... **EXPERIENCE AND SKILLS:** + 3+ years dialysis experience required + 3+ years management experience in a clinical leadership role + Strong organizational,… more
- Edwards Lifesciences (Springfield, MA)
- …post-case management , 3 Mensio management , Therapy Awareness program management and clinical education programs. + Implementing sales and educational ... and implementing growth strategies within focused accounts in partnership with Sales Management . + Developing clinical champions among current and potential… more
- Hartford HealthCare (Manchester, CT)
- …Hospital, a 102-bed facility, a large multispecialty provider group and visiting nurse services. The Greater Manchester Region serves a region of 300,000 people ... group and individual counseling sessions for students, providing conflict resolution, anger management and behavior management strategies to students. The School… more
- Hartford HealthCare (Hartford, CT)
- …specialties. The primary responsibility of the Metabolic and Bariatric Surgical/Medical Clinical Reviewer (MBSCR) is to ensure the accurate and timely collection, ... Medical Weight Loss team, and the Quality Department to identify opportunities for clinical excellence and special projects. The MBSCR is granted access to all… more
- Baystate Health (Springfield, MA)
- …the facilitation of accurate patient placement into the health system based on clinical relevance, with integration of care management skills to support ... management as outlined in the evidence based practice guidelines + Uses Utilization Analysis / Management principles, insures that patient's site of care… more
- Moses/Weitzman Health System (Hartford, CT)
- …component meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and ... licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or… more
- Hartford HealthCare (Torrington, CT)
- …team of caregivers and physicians that utilize advanced technology and clinical partnerships in a convenient, safe and comfortable patient environment. *_POSITION ... SUMMARY/PURPOSE_* Care Management is a collaborative practice model including patients, nurses,...achievement of optimal health, access to care and appropriate utilization of resources balanced with the patient's right to… more
- Baystate Health (Springfield, MA)
- …resources across Baystate Health. Reporting to the Vice President of Clinical Business Operations, this position facilitates optimal staffing levels, supports ... evaluate centralized staffing models and strategies to optimize nursing resource utilization across all Baystate Health facilities and units, considering patient… more
- Hartford HealthCare (Vernon, CT)
- …Hospital, a 102-bed facility, a large multispecialty provider group and visiting nurse services. The Greater Manchester Region serves a region of 300,000 people ... agency policies and procedures. *Supervision Received:*Reports directly to a Clinical Manager. *Supervision Exercised:*Home Care Aides. *Education:*Graduate of an… more