- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Providence, RI)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience ... 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 Appeals and… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. * 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. * ... Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The PA Nurse uses a multidisciplinary approach to review service requests (prior-authorizations),… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM ... to learn more about joining our team as a Utilization Review Nurse Coordinator! The State of...types of case reviews for quality and appropriate medical management , cost containment, peer review and rehabilitation; + Implement… more
- Hartford HealthCare (Willimantic, CT)
- …**Title:** *Registered Nurse Case Manager (RN) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community Memorial (10183)* ... resources. Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and… 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 ... MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate +… more
- Hartford HealthCare (Manchester, CT)
- …timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and ... responsible for preoperative, concurrent, and retrospective reviews in accordance with the utilization management plan. The UM CM ensures the appropriate status… more
- CVS Health (Woonsocket, RI)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Baystate Health (Springfield, MA)
- … driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... - Maximum $31.15 - $35.81 - $42.36 **Licensed Practical Nurse (LPN), Inpatient Medical Telemetry Unit** Baystate Health, a...Excellence is looking for a medical inpatient Licensed Practical Nurse to join our team in Springfield, MA. A… more
- Hartford HealthCare (Manchester, CT)
- …balance. Every moment matters. And this is your moment. **Job:** ** Management * **Organization:** **Manchester Memorial Hospital* **Title:** * Nurse Manager (RN, ... part of Connecticut's most comprehensive healthcare network as a Nurse Manager. The Greater Manchester Region has approximately 2,500...people in 19 towns. POSITION SUMMARY: Responsible for the management of more than one defined area of organized… more
- Baystate Health (Springfield, MA)
- … driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... Hospital for Nursing Excellence is looking for a medical inpatient Licensed Practical Nurse to join our team in Springfield, MA. **Our medical unit offers… more
- Evolent (Providence, RI)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Hartford HealthCare (Norwich, CT)
- …the following activities: * Provides staff guidance in making clinical and case management decisions focused on clinical excellence for end of life care and symptom ... management . Directs staff in the Medicare Hospice Benefit guidelines...clinical software to identify opportunities for education, most appropriate utilization of services, oversee clinical progression of patients and… more
- Hartford HealthCare (Norwich, CT)
- …balance. Every moment matters. And this is*your moment.* **Job:** ** Management * **Organization:** **Backus Hospital* **Title:** *Assistant Nurse Manager ... more about you! *JOB SUMMARY* The Assistant Nursing manager is a Registered Nurse (RN) who has responsibility for the supervision of patient care, clinical… more
- UCFS Healthcare (Norwich, CT)
- Per Diem Primary Care Nurse -RN/LPN Norwich, CT (http://maps.google.com/maps?q=47+Town+Street+Norwich+CT+USA+06360) Job Type Part-time Description UCFS is looking for ... the lives of others!We are currently seeking apart-time (per diem 16hrs) Nurse , RN/LPNwho will utilize critical thinking skills to interpret complex information in… more
- UCFS Healthcare (Norwich, CT)
- Pediatric Walk-In Center Nurse -RN/LPN Norwich, CT (http://maps.google.com/maps?q=47+Town+Street+Norwich+CT+USA+06360) Job Type Part-time Description UCFS is looking ... the lives of others!We are currently seeking apart-time (per diem 10hrs) Nurse , RN/LPNwho will utilize critical thinking skills to interpret complex information in… more
- Hartford HealthCare (Norwich, CT)
- …balance. Every moment matters. And this is*your moment*. **Job:** ** Management * **Organization:** **Backus Hospital* **Title:** *Assistant Nurse Manager ... of our communities. *JOB SUMMARY* The Assistant Nursing manager is a Registered Nurse (RN) who has responsibility for the supervision of patient care, clinical… more
- Baystate Health (Springfield, MA)
- …nurse driven change projects including activity/mobility tool, acuitybased assignments, capacity management workflow, and foley utilization . + The Manager is ... a Magnet Hospital for Nursing Excellence is looking for a New Graduate Registered Nurse to join our team in Springfield, MA. At Baystate Health, RN means more.… more
- Baystate Health (Springfield, MA)
- … driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... a Magnet Hospital for Nursing Excellence is looking for a medical inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, RN means more.… more
- Evolent (Providence, RI)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more