- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse / RN -Licensure-by-Endorsement) ... Utilization Review Nurse Coordinator...Regulatory requirements and private insurances as it relates to utilization review / management and quality of… more
- Highmark Health (Hartford, CT)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements the 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
- Humana (Hartford, CT)
- …hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse ( RN ) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- Elevance Health (Wallingford, CT)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... ** RN Hospital Bill Audit/Appeal Lead** **Supports the Carelon...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through… more
- Lincoln Financial Group (Hartford, CT)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
- Hartford HealthCare (Meriden, CT)
- …including customer service representatives, admission specialist in the Call Center, Utilization Management for residential services. The Director ensures high ... receive a exceptional customer services and ease of access. *Job Responsibilities* 1. Review , revise and develop policy and procedures as they relate to access… more
- Hartford HealthCare (West Hartford, CT)
- …- *Stroke GOLD PLUS Achievement Award winner* in 2016. *Physician Assistant or Nurse Practitioner (APRN) Role Scope* Along with practicing as a full time, clinical ... meets with their teams routinely (monthly) to provide updates, review areas for improvement, and listen and respond to...coordinating scheduling. Assists in determining suitability for team member utilization of PTO and CME excused time. . Assists… more