Portal of Entry (ED) Utilization Management Nurse- 32hr- Onsite
Connecticut Children's · Hartford, Connecticut, US
Applicants must be residents of Connecticut, Massachusetts, or New York to be considered for this position.
Job description
Applicants must be residents of Connecticut, Massachusetts, or New York to be considered for this position. The Center: Connecticut Children’s Center for Care Coordination (The Center) is dedicated to the integration of care coordination through the delivery of innovative programs, providing technical assistance, disseminating best practices, and building inclusive partnerships to strengthen families and build stronger communities. The Center utilizes a universal, evidence based, research informed, and policy driven approach to enhanced care coordination that not only meets the interrelated medical, developmental, behavioral, and social needs of children, but enhances the care giving capacity of families. This team reports to The Center for their leadership. Position Details: The Portal of Entry Utilization Management Nurse (POE) has strong clinical skills and a well-developed knowledge of utilization management, with a focus on medical necessity determinations. The candidate should possess a working knowledge of medical necessity tools such as InterQual® and Milliman Care Guidelines® and be proficient in medical record reviews. This individual supports the Care Management program...