- CenterWell (Hartford, CT)
- …our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- CVS Health (CT)
- … Nurse Consultant** Fully Remote- WFH- 8A-5P in EST or CST **Position Summary** UM Nurse Consultant Utilizes clinical experience and skills in a ... options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline,… more
- Evolent (Hartford, CT)
- …coordinating with UM staff to ensure timely and accurate communication of clinical decisions. + Responsible for completion of UM projects and participation ... the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Vascular Surgey is responsible for support and… more
- Evolent (Hartford, CT)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member...medical management activities in a managed care environment + UM /UR experience + Clinical experience in Oncology,… more
- Hartford HealthCare (Manchester, CT)
- …moment **Job:** **Care/Case Management* **Organization:** **Manchester Memorial Hospital* **Title:** * Clinical Resource Management Nurse (RN) - Case ... Hospital, a 102-bed facility, a large multispecialty provider group and visiting nurse services. The Greater Manchester Region serves a region of 300,000 people… more
- Highmark Health (Hartford, CT)
- …experience, or provider operations and/or health insurance experience + 1 year in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year ... panel of members that range in health status/severity and clinical needs; and assesses health management needs of the...RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or… more
- Nuvance Health (Danbury, CT)
- …Current licensure as a registered nurse (RN) * Minimum of 5 years of clinical experience in an acute care setting * Minimum of 5 years of progressive leadership ... for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while partnering with local case management leadership. This… more
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