- CVS Health (CT)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CVS Health (CT)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 3+ years of ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may...schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote- WFH- 8A-5P in EST or… more
- CenterWell (Hartford, CT)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- CenterWell (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… 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 ... *Description* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions...the interdisciplinary care team * Current working knowledge of utilization management , performance improvement and managed care… more
- CVS Health (CT)
- …Monday through Friday 8:30-5pm EST. No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… 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 (Hartford, CT)
- …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
- Highmark Health (Hartford, CT)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Hartford HealthCare (Hartford, CT)
- …context of the framework for professional nursing practice, the Cystic Fibrosis Clinic Nurse Navigator is a registered nurse experienced in patient throughput, ... appropriate practices, standards, protocols and guidelines. This position reports to a Nurse Manager Manager. **Job Responsibilities:** * Functions as a member of an… more