- Humana (Hartford, CT)
- **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
- CVS Health (Hartford, CT)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… more
- CenterWell (Hartford, CT)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Cognizant (Hartford, CT)
- …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
- Nuvance Health (Danbury, CT)
- …in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum ... members of the interdisciplinary care team * Current working knowledge of utilization management , performance improvement and managed care reimbursement. Working… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …LOCATION: 1000 Silver Street, Middletown, CT + UNIT: Addiction Services Division (ASD) Utilization Management + SCHEDULE: Full-Time, 37.5 Hours per Week, First ... Utilization Review Nurse (37.5 Hour) Office/On-Site...of the General Experience. PREFERRED QUALIFICATIONS + Experience with Utilization Review and Management in a healthcare… more
- CVS Health (Hartford, CT)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Hartford HealthCare (Bridgeport, CT)
- …individual in this role provides clinical staff with guidance on documentation, utilization , and patient care decisions to support optimal clinical and operational ... outcomes. They review visit utilization for care appropriateness and collaborate with clinicians on...accredited educational program leading to licensure as a Registered Nurse (RN), Physical Therapist (PT), Occupational Therapist (OT), or… more
- Veterans Affairs, Veterans Health Administration (West Haven, CT)
- Summary The Registered Nurse -Resource Pool Nurse position is located in Nursing Operations at the West Haven, CT. This position is intermittent. Responsibilities ... The Resource Pool Registered Nurse (RN) demonstrates proficiency in practice based on conscious...for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care.… more
- Hartford HealthCare (Hartford, CT)
- …Diseases provides inpatient and outpatient consultation regarding the diagnosis and management of all types of infectious diseases. The service is supported ... the context of the framework for professional nursing practice, the Community Care Nurse Navigator is a registered nurse experienced in patient throughput,… more
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