Utilization Review Jobs in Hartford
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Search Results - Utilization Review Jobs in Hartford
Medix™-Hartford-
nursing role. You’ll work through clinical cases, review the information available, identify what is missing, determine the appropriate next step, and escalate when needed.
The work can touch prior authorization, utilization review, care coordination...
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American Traveler-Springfield (MA), 22 mi from Hartford-
to confirmation) with tax
• free stipend amount to be determined.
Posted job title: Travel RN
• Case Management/Utilization Review
• Case Management
About American Traveler
With over 25 years of experience, American Traveler has established a reputation...
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Medix™-Hartford-
brings proven experience conducting utilization reviews within a SNF, health plan, or managed care setting, alongside strong clinical judgment and the ability to collaborate effectively across interdisciplinary teams, healthcare providers, and payers...
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Lifepoint Health®-Holyoke (MA), 29 mi from Hartford-
statements and reports
• Ensure legal compliance on all financial functions
• Manage relationships with banks
• Supervise and oversee the activities of the business office staff (billing, collections, financial counseling, utilization review and data...
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TALENT Software Services-Hartford-
of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...
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Natchaug Hospital-Norwich (CT), 34 mi from Hartford-
of care and available resources that promote the individualized care plan.
• Assists in the coordination of programming which may include staff scheduling, scheduling clinical activities, program development, utilization review, case load assignment...
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Well Behavioral Health-Hartford-
including refill requests and
pharmacy coordination, within clinic protocols
• Provide services via telehealth consistent with 14 NYCRR Part 596
• Participate in quality improvement, utilization review, and peer review activities as required by
OMH...
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New England Rehabilitation Hospital of Portland, a Joint Venture of Maine Medical Center and Encompass Health-North Windham (CT), 27 mi from Hartford-
Ensure accuracy of discharge and payor-related information in the patient record.
• Participate in utilization review process: data collection, trend review, and resolution actions.
• Participate in case management on-call schedule as needed...
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Optum-Hartford-
Additionally, performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and participates in the Quality Improvement programs for the company.
The Medical Director also provides/assists in the direction...
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360X Staffing-Hartford-
oversight, medical expertise, and operational support for physical health services. This position ensures high quality, evidence based medical review processes and supports organizational goals related to clinical quality, utilization management, and care...
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