Top 25 Utilization review nurse Jobs in Bloomfield, Ct

Clinical Resource Mgmt Nurse / Clinical Resource Management
Hartford HealthCare Corp. —Wethersfield, CT
- Weekends as needed
- Nursing
- RN License
- 5 years
Quick Apply
Portal of Entry (ED) Utilization Management Nurse- 32hr- Onsite
Connecticut Children's Medical Center —Hartford, CT
- Nursing
- RN License
- Bachelor of Science
Utilization Management Registered Nurse RN
Trinity Health Of New England —Hartford, CT
- Full-time
- Hybrid work
- Nursing
- RN License
- Bachelor of Science
1d
Center for Care Coordination-Team Lead Utilization Review Nurse- Full Time
Connecticut Children's Medical Center —Hartford, CT
- Full-time
- Nursing
- RN License
- Bachelor of Science
Travel RN - Case Management/Utilization Review - Case Management
American Traveler —Farmington, CT
- $2,922 a week
- Contract
- RN License
- BLS Certification
- Mid-level
- Travel reimbursement
- Health insurance
Quick Apply
8d
RN Supervisor, 3-11 shift, Monday-Friday
Waterbury Center for Nursing and Rehabilitation —Waterbury, CT
- $50 - $55 an hour
- Full-time
- Nursing
- Anatomy knowledge
- Blood sampling
Quick Apply
4d
Registered Nurse Emergency Department Case Manager RN
Trinity Health Of New England —Hartford, CT
- 12 hour shift
- Acute care
- Nursing
- RN License
Quick Apply
1d
RN Case Coordinator
Hartford Hospital —Hartford, CT
- Full-time
- Nursing
- RN License
- Inpatient
Quick Apply
RN Clinical Case Manager
University of Connecticut —Farmington, CT
- Rotating weekends
- Nursing
- RN License
- Inpatient
10d
Clinical Case Manager
Waterbury Hospital —Waterbury, CT
- Part-time
- Nursing
- RN License
- Hospital
RN Discharge Planner
Glastonbury Center for Health & Rehabilitation —Glastonbury, CT
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
- Retirement plan
RN Case Manager
Baystate Health —Springfield, MA
- $98,051 - $133,348 a year
- Full-time
- Nursing
- RN License
- Hospital
- Continuing education credits
- 403(b) matching
Care Coordinator (RN) - Social Work
MidState Medical Center —Meriden, CT
- Full-time
- Acute care
- Nursing
- RN License
Quick Apply
RN Clinical Manager - Behavioral Health
Optum —Rocky Hill, CT
- $59,664 - $89,496 a year
- Full-time
- Nursing
- RN License
- Pass drug screening
Quick Apply
1d
MDS Coordinator Experienced!!!
Meriden Health & Rehab —Meriden, CT
- Full-time
- Anatomy knowledge
- Skilled nursing facility
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Case Manager - FT Days | Waterbury Rehab
PAM Health, LLC —Waterbury, CT
- Full-time
- RN License
- Hospital
- BLS Certification
- Health savings account
- Disability insurance
Quick Apply
22h
Advanced Practice Registered Nurse - Part-Time
Boca Recovery Center —Hartford, CT
- Part-time
- CPR Certification
- Nursing
- Psychiatry
- Disability insurance
- Health insurance
Quick Apply

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The Bridge Family Center —West Hartford, CT
The RN Supervisor shall have a valid driver’s license, a safe and roadworthy vehicle and be willing to transport residents in this vehicle as may be necessary…
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Home Care RN - Hartford - Virtual Hiring Event $10,000 Sign-on Bonus
Trinity Health At Home Of New England —Hartford, CT
Licensure as a Registered Nurse in the state of Connecticut. A Catholic-based, non-profit organization, we serve patients and their loved ones with home care (…

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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
Case Manager (RN) - Full-Time
OhioHealth Rehabilitation Hospital —Columbus, OH
Current Licensure per state guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline.
$70,000 - $84,000 a year
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3d

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Clinical Resource Mgmt Nurse / Clinical Resource Management

Hartford HealthCare Corp. -
Wethersfield, CT

Quick Apply

Job Details

Full-time

Qualifications

RN License
Healthcare reimbursement methods
Negotiation

Full Job Description

Location Detail: 1290 Silas Deane Hwy Wethrsfld (10181)

Shift Detail: M-F 8:00am to 4:30pm with alternating weekends and holidays

Work where every moment matters.

Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.

With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Integrated Care Partners (ICP) is a physician-led, clinically integrated health care network whose mission is to assist our members in providing the highest quality care at the most reasonable cost for our patients in the current, rapidly changing medical environment.

Position Summary:

The Clinical Resource Management Nurse is an integral part of the Care Management team whose focus is on performing a timely level of care assessment ideally at the immediate point of entry into the health system to ensure that patients are assigned the most appropriate patient class based on their clinical needs incorporating the judgment of their provider. The Clinical Resource Management Nurse is able to work autonomously and swiftly, managing a high volume of complex cases across all HHC system hospitals.

Position Responsibilities:

Apply standard criteria and guidelines to assist in determining and/or to validate the patient class assigned by the provider.
Document review and findings as well as any additional information relevant to the case as directed and appropriate.
Partner with the Emergency Department and/or the Admitting Provider to ensure the patient class assigned is appropriate given the patient’s clinical presentation.
Act as a resource and subject matter expert to the Emergency Department and/or the Admitting Provider on aspects of patient class and level of care determination.
Escalate cases to designated Physician Advisor resource when assigned level of care is not appropriate and Emergency Department or Admitting Provider is unwilling to consider recommendations for alternative.
Maintain knowledge of industry standards and regulatory requirements which influence patient class and level of care determinations.
Provide education sessions to constituency groups as needs are identified and/or as requested.
Support needs of the department in the event of a critical demand or a decrease in volumes by performing a review of work ques, crafting appeal responses, etc.
Ensure any information critical to the care and progression of the patient gleaned during the review process is relayed to the Care Manager responsible for the patient.
Complete assignments to demonstrate expert knowledge of criteria as requested.
Other duties as assigned.

Qualifications

Education: Registered Nurse is required. BSN in Nursing is preferred

Experience: At least five (5) years of relevant clinical experience. Acute care or managed care utilization review is preferred.

Licensure, Certification, Registration: Current State of Connecticut RN license

Knowledge, Skills and Ability Requirements:

Familiarity with clinical care
Able to influence and negotiate
Critical thinking, astute assessment and confident in decision making
Strong interpersonal and communication skills
Knowledge of Interqual or equivalent criteria and reimbursement guidelines

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

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utilization review nurse jobs in bloomfield, ct

Clinical Resource Mgmt Nurse / Clinical Resource Management

Portal of Entry (ED) Utilization Management Nurse- 32hr- Onsite

Utilization Management Registered Nurse RN

Center for Care Coordination-Team Lead Utilization Review Nurse- Full Time

Travel RN - Case Management/Utilization Review - Case Management

RN Supervisor, 3-11 shift, Monday-Friday

Registered Nurse Emergency Department Case Manager RN

RN Case Coordinator

RN Clinical Case Manager

Clinical Case Manager

RN Discharge Planner

RN Case Manager

Care Coordinator (RN) - Social Work

RN Clinical Manager - Behavioral Health

MDS Coordinator Experienced!!!

Case Manager - FT Days | Waterbury Rehab

Advanced Practice Registered Nurse - Part-Time

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