UNKNOWN

FEED

Working at the intersection of clinical expertise, healthcare data, reimbursement, coding, medical policy, Payment Integrity, and business strategy, this role will translate emerging medical expense trends, clinical practices, coding and reimbursement changes, policy developments, healthcare utilization patterns, and industry intelligence into actionable Payment Integrity opportunities. This role will collaborate across Payment Integrity and with Medical Policy, Clinical, Analytics and Decision Science, Technology, Operations, Product, Compliance, SIU, Network, Provider organizations, and vendor partners to move opportunities from initial idea through validation, business-case development, prioritization, governance, and implementation readiness.

<p>CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all. </p>

CVS Health

Senior Clinical Strategist - Aetna Payment Integrity – Ideation & Affordability

sourcestack_via_bold

In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.

YEAR

<p>CorVel is a leader of risk and healthcare management solutions to employers, third party administrators, insurance companies and government agencies. We are publicly traded (NASDAQ:CRVL) and annual revenues exceeded $493 million in FY2015. Our continued customer growth is a testament to our financial stability and our significant investments in new systems and technologies allows us to continue to deliver industry-leading solutions to the marketplace. CorVel has approximately 3,500 associates who serve more than 2,000 customers through a national branch office network covering all 50 states.</p>

CorVel Corp

Medical Case Manager II

linkup_via_bold

The ADN on the day shift will act as a liaison between clinical units, case management, bed management, providers, staffing office and nursing leadership to help facilitate efficient nursing operations and patient throughput. They will monitor performance using best practice measures to drive operational excellence as well as display strong analytical skills with an emphasis on operational logistics with collegial interpersonal and change leadership skills.

Yale New Haven Health

ADN - Off Shift Supervisor

Approximately 7,000 clients receive services in a variety of programs, including peer support programs, recovery services, supported employment, homeless services, residential, crisis services, jail diversion, outpatient, case management, Assertive Community Treatment Teams (ACTT) and young adult services. DMHAS is a health care agency whose mission is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective, and efficient services and supports that foster dignity, respect, and self-sufficiency in those we serve.

State of Connecticut

Mental Health Center Director(Office/On-Site)

You will be responsible for providing telephonic medical case management which includes facilitating communications between employers, injured employees, healthcare providers and claims professionals to coordinate return to work and medical care plans on claims involving disability and medical treatment. Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner and in accordance with State rules and guidelines to obtain optimum value for both the customer and the reimbursement source.

Intact Insurance

Senior Medical Case Specialist (Hybrid)

ea_via_bold

Onebeacon Professional Insurance Inc

PART_TIME

In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.

CorVel Healthcare Corporation

Performs Selected Procedures Such As Specimen Collections (Vre Swabs, Urine, Stool And Non-Induced Sputum); Urine Testing, Hematest, Gastrocult, Enemas, Application Of Ice Collar/Caps Or Post Mortem Care. Assists With Basic Patient Care (Including Am & Pm Care, Toileting, Peri-Care, Emptying And Rinsing Of Drainage Devices, And Feeding) Under The Supervision Of The Licensed Nurse.

Float Pool PCA

OTHER

3. Performs Selected Procedures Such As Specimen Collections (Vre Swabs, Urine, Stool And Non-Induced Sputum); Urine Testing, Hematest, Gastrocult, Enemas, Application Of Ice Collar/Caps Or Post Mortem Care. Assists With Basic Patient Care (Including Am & Pm Care, Toileting, Peri-Care, Emptying And Rinsing Of Drainage Devices, And Feeding) Under The Supervision Of The Licensed Nurse.

[AW]-iCims

Under The Delegation And Supervision Of An Rn, Provides Clinical Support With Basic Nursing Care And Patient Monitoring For The General Welfare And Safety Of All Patients. High school graduate or equivalent and graduate of an accredited nursing assistant program or equivalent (equivalent may be defined as a student nurse).

Patient Care Attendant

2. Performs Selected Procedures Such As Specimen Collections (Vre Swabs, Urine, Stool And Non-Induced Sputum); Urine Testing, Hematest, Enemas, Application Of Ice Collar/Caps Or Post Mortem Care. Under The Delegation And Supervision Of An Rn, Provides Clinical Support With Basic Nursing Care And Patient Monitoring For The General Welfare And Safety Of All Patients.

4.1 NEURO PCA

Full-time day PCA 5.2

Performs Selected Procedures Such As Specimen Collections (Vre Swabs, Urine, Stool And Non-Induced Sputum); Urine Testing, Hematest, Enemas, Application Of Ice Collar/Caps Or Post Mortem Care. Under The Delegation And Supervision Of An Rn, Provides Clinical Support With Basic Nursing Care And Patient Monitoring For The General Welfare And Safety Of All Patients.

PCA - 4.1 Neuro

4.2 Inpatient Surgery PCA

The position is responsible for facilitating continuous throughput of patients from all points of entry within the Hartford HealthCare system by utilizing effective verbal communication, reviewing technology that supports patient placement activities, and swift clinical decision making. Collaborates with clinical management in the identification of patient needs related to changes in clinical condition, emergent transfers and trauma calls associated with bed management activities/placement efforts.

Hartford HealthCare Corp

Care Logistics EMS Dispatcher / Care Logistics Center

Implements Actions To Prevent Patient Injury From: Positioning, Extraneous Objects, Medications, Infection, Chemical/Physical/Electrical Hazards. Implements Case Breakdown Procedure Insuring Minimal Downtime Between Cases / Assists In Room Turnover.

Certified Surgical Technician - LMH OR *Sign-on Bonus up to $10,000*

As directed by Physician or Advanced Practice Registered Nurse (APRN), schedules and conducts individual, family, And couple's therapy meetings, and actively participates in patient and family/significant other(s) education. Effectively manages crisis situations/routine treatment interactions with due respect for patient rights, legal/ethical obligations, and therapeutic goals of any intervention used.

License Clinical Social Worker II - Full Time

POND License Clinical Social Worker - Full Time

The Oncology Medical Director will run the overall clinical governance, review adverse determinations, provide Physician to Physician reviews, and consult with the team on complex medical necessity decisioning. The Oncology Medical Director will support a variety of team members in the Oncology Care Model including a Nurse Practitioner, Nurse, Pharmacist, Behavioral Health Specialist and Oncology Companion.

Utilization Management Nurse Jobs in Connecticut

Senior Clinical Strategist - Aetna Payment Integrity – Ideation & Affordability CVS Health

Medical Case Manager II CorVel Corp

ADN - Off Shift Supervisor Yale New Haven Health

Mental Health Center Director(Office/On-Site) State of Connecticut

Senior Medical Case Specialist (Hybrid) Intact Insurance

Senior Medical Case Specialist (Hybrid) Onebeacon Professional Insurance Inc

Medical Case Manager II CorVel Healthcare Corporation

Float Pool PCA Yale New Haven Health

Float Pool PCA Yale New Haven Health

Patient Care Attendant Yale New Haven Health

4.1 NEURO PCA Yale New Haven Health

Full-time day PCA 5.2 Yale New Haven Health

PCA - 4.1 Neuro Yale New Haven Health

4.2 Inpatient Surgery PCA Yale New Haven Health

Care Logistics EMS Dispatcher / Care Logistics Center Hartford HealthCare Corp

Certified Surgical Technician - LMH OR Sign-on Bonus up to $10,000 Yale New Haven Health

License Clinical Social Worker II - Full Time Yale New Haven Health

POND License Clinical Social Worker - Full Time Yale New Haven Health

CST Yale New Haven Health

Oncology Medical Director CVS Health Corp

Similar Job Searches

Stand out to leading employers.

Utilization Management Nurse Jobs in Connecticut

Senior Clinical Strategist - Aetna Payment Integrity – Ideation & Affordability CVS Health

Medical Case Manager II CorVel Corp

ADN - Off Shift Supervisor Yale New Haven Health

Mental Health Center Director(Office/On-Site) State of Connecticut

Senior Medical Case Specialist (Hybrid) Intact Insurance

Senior Medical Case Specialist (Hybrid) Onebeacon Professional Insurance Inc

Medical Case Manager II CorVel Healthcare Corporation

Float Pool PCA Yale New Haven Health

Float Pool PCA Yale New Haven Health

Patient Care Attendant Yale New Haven Health

4.1 NEURO PCA Yale New Haven Health

Full-time day PCA 5.2 Yale New Haven Health

PCA - 4.1 Neuro Yale New Haven Health

4.2 Inpatient Surgery PCA Yale New Haven Health

Care Logistics EMS Dispatcher / Care Logistics Center Hartford HealthCare Corp

Certified Surgical Technician - LMH OR *Sign-on Bonus up to $10,000* Yale New Haven Health

License Clinical Social Worker II - Full Time Yale New Haven Health

POND License Clinical Social Worker - Full Time Yale New Haven Health

CST Yale New Haven Health

Oncology Medical Director CVS Health Corp

Similar Job Searches

Certified Surgical Technician - LMH OR Sign-on Bonus up to $10,000 Yale New Haven Health