- Humana (Hartford, CT)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with no… more
- The Cigna Group (Bloomfield, CT)
- …rehab facilities, home health care, care management , and utilization review . The Registered Nurse is responsible for the implementation, evaluation, ... The Registered Nurse will perform clinical and...The Registered Nurse will perform clinical and operational processes related...of clinical experience + 2 + years experience in utilization management preferred. + Home health, SNF,… 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
- 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
- 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
- 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
- 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
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …facility cottages (PRTF). We are seeking an exceptional professional who holds a valid Registered Nurse ( RN ) license in the State of Connecticut and ... THE BASE ANNUAL SALARY, YOU MAY BE APPROVED FOR AN ADDITIONAL COMPENSATION BONUS: Each Registered Nurse who is permanently assigned to the second or third shift… more