- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 250102-5612FP-001 Location Hartford, CT Date Opened 1/6/2025 12:00:00 AM Salary $78,480 - ... 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
- The Cigna Group (Bloomfield, CT)
- …nursing and inpatient rehab facilities, home health care, care management , and utilization review . The Registered Nurse is responsible for the ... The Registered Nurse will perform clinical and operational processes related...of clinical experience + 2 + years experience in utilization management preferred. + Home health, SNF,… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Head Nurse (40 Hour) Recruitment # 241216-4356FL-100 Location Middletown, CT Date Opened 1/10/2025 12:00:00 AM Salary $91,192 - $120,638/year Job Type Open to the ... Families ( DCF ) is recruiting one (1) Head Nurse for an anticipated position to join our Psychiatric...compassionate environment while applying your good organizational and time management abilities to maintain high standards of efficiency. Your… 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
- Evolent (Hartford, CT)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… 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 ... behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...and regulations. * Practices and maintains the principles of utilization management and appeals management … more
- Hartford HealthCare (Hartford, CT)
- …as part of the stroke service care delivery team at Hartford Hospital . Management & oversight of Neurology /Stroke/ APP team . Oversees day to day operations ... and multidisciplinary care team, including quality of care measures and review . . Collaboration with other departments caring for Neurology/stroke patients (incl.… more
- Baystate Health (Springfield, MA)
- …and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers ... Per Diem The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality,...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- Masonicare (Colchester, CT)
- …staff, prepares on-call schedules, plans and organizes daily assignments including the review and assignment of new patient referrals. + Supervises all assigned ... provides direction and reviews work. Participates in and provides coordination and management of all professional services rendered to clients and families by agency… 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. ... The role assumes staffing and leadership responsibilities in support of nursing management . All employees in this position are considered 'Essential Employees' and… more