• Utilization Management Behavioral…

    Humana (Hartford, CT)
    **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
    Humana (03/18/25)
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  • Pre-Authorization Registered Nurse

    Humana (Hartford, CT)
    …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… more
    Humana (03/15/25)
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  • Manager, Utilization Management

    Humana (Hartford, CT)
    …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
    Humana (03/12/25)
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  • RN , Pediatric Nurse Care Manager…

    Baystate Health (Springfield, MA)
    …- American Heart AssociationAmerican Heart Association, Driver License - OtherOther, Registered Nurse - State of MassachusettsState of Massachusetts **Equal ... ** RN , Pediatric Nurse Care Manager -...management application is required and is vital. Care management program metrics including, emergency room utilization ,… more
    Baystate Health (02/13/25)
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  • RN , Hospital Case Manager -Per Diem

    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
    Baystate Health (01/22/25)
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  • RN Medicare Compliance

    Sedgwick (Hartford, CT)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
    Sedgwick (02/14/25)
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  • LPN, ACO Care Manager - Behavioral Health

    Baystate Health (Springfield, MA)
    …care management application is required and is vital. Care management program metrics including, emergency room utilization , and hospital ... & Transitions of Care Team_** is responsible for the management of care for a defined group of patients...of care and revise it as necessary to meet goals. RN to provide a final review of… more
    Baystate Health (02/07/25)
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  • Patient Care Coordinator and Wound Care Specialist

    Eastern Connecticut Health Network (Vernon, CT)
    …be a graduate of an accredited school of Nursing and have and maintain a current Registered Nurse license in the State of Connecticut. Must provide a copy of ... Why consider applying to Visiting Nurse & Health Services of CT? Here are...provided by clinicians through conferences, home visits and record review . Also has responsibility for the wound care program.… more
    Eastern Connecticut Health Network (03/08/25)
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  • Schedule Coordinator

    Baystate Health (Springfield, MA)
    …The Schedule Coordinator will be responsible for scheduling contingency staff as needed: RN s, PCTs, OAs, OA/MTs and any additional staff that may be needed ... also field employee sick calls and search for replacements as needed; review schedules in advance for pre-scheduling known unfilled shifts (Vacation, FMLA, etc.)… more
    Baystate Health (03/07/25)
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