Hamden, CT · On-site
$60/hr
RN Utilization Management - $60/hr - Hamden, CT Hamden, Connecticut, United States Or refer someone Job Openings RN Utilization Management - $60/hr - Hamden, CT About the Job RN Utilization ...
Hamden, CT · On-site
$60/hr
RN Utilization Management - $60/hr - Hamden, CT Hamden, Connecticut, United States Or refer someone Job Openings RN Utilization Management - $60/hr - Hamden, CT About the Job RN Utilization ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
The Team Lead for Utilization Review (UR) is responsible for the day-to-day activities and ... Work with Manager to establish and track metrics, data and initiatives that improve process * UR ...
The Team Lead for Utilization Review (UR) is responsible for the day-to-day activities and ... Work with Manager to establish and track metrics, data and initiatives that improve process * UR ...
The Team Lead for Utilization Review (UR) is responsible for the day-to-day activities and ... Work with Manager to establish and track metrics, data and initiatives that improve process * UR ...
The Team Lead for Utilization Review (UR) is responsible for the day-to-day activities and ... Work with Manager to establish and track metrics, data and initiatives that improve process * UR ...
Educate physicians and clinical teams on utilization management best practices, documentation, and evolving regulatory standards. Participate in quality improvement initiatives that enhance patient ...
Educate physicians and clinical teams on utilization management best practices, documentation, and evolving regulatory standards. Participate in quality improvement initiatives that enhance patient ...
This physician leader serves as a clinical resource for utilization management, level of care determinations, regulatory compliance, and physician education. The ideal candidate combines strong ...
This physician leader serves as a clinical resource for utilization management, level of care determinations, regulatory compliance, and physician education. The ideal candidate combines strong ...
This physician leader serves as a clinical resource for utilization management, level of care determinations, regulatory compliance, and physician education. The ideal candidate combines strong ...
This physician leader serves as a clinical resource for utilization management, level of care determinations, regulatory compliance, and physician education. The ideal candidate combines strong ...
This physician leader serves as a clinical resource for utilization management, level of care determinations, regulatory compliance, and physician education. The ideal candidate combines strong ...
This physician leader serves as a clinical resource for utilization management, level of care determinations, regulatory compliance, and physician education. The ideal candidate combines strong ...
Hartford, CT · On-site
$230 - $320/hr
Medical
Retirement
Lead medical oversight for utilization management, case management, and clinical review processes. * Evaluate complex medical cases for medical necessity and cost-effectiveness. * Guide the ...
Hartford, CT · On-site
$230 - $320/hr
Medical
Retirement
Lead medical oversight for utilization management, case management, and clinical review processes. * Evaluate complex medical cases for medical necessity and cost-effectiveness. * Guide the ...
This role focuses on early identification of patient needs, care coordination, utilization management, and safe transitions of care to ensure highquality, costeffective outcomes while supporting ...
This role focuses on early identification of patient needs, care coordination, utilization management, and safe transitions of care to ensure highquality, costeffective outcomes while supporting ...
Hartford, CT · On-site
$263K - $305K/yr
Medical
Retirement
Lead medical oversight for utilization management, case management, and clinical review processes. * Evaluate complex medical cases for medical necessity and cost-effectiveness. * Guide the ...
Quick apply
Hartford, CT · On-site
$263K - $305K/yr
Medical
Retirement
Lead medical oversight for utilization management, case management, and clinical review processes. * Evaluate complex medical cases for medical necessity and cost-effectiveness. * Guide the ...
This role focuses on early identification of patient needs, care coordination, utilization management, and safe transitions of care to ensure highquality, costeffective outcomes while supporting ...
This role focuses on early identification of patient needs, care coordination, utilization management, and safe transitions of care to ensure highquality, costeffective outcomes while supporting ...
Bristol, CT · On-site
The Physician Advisor serves as a liaison between the medical staff, Care Management, Utilization Management, Clinical Documentation Integrity, Revenue Cycle, Quality, and other hospital departments.
Bristol, CT · On-site
The Physician Advisor serves as a liaison between the medical staff, Care Management, Utilization Management, Clinical Documentation Integrity, Revenue Cycle, Quality, and other hospital departments.
Farmington, CT · On-site
$36.75 - $49.75/hr
Team Lead For Utilization Review (Ur) The team lead for utilization review (ur) is responsible for ... Work with manager to establish and track metrics, data and initiatives that improve process * Ur ...
Farmington, CT · On-site
$36.75 - $49.75/hr
Team Lead For Utilization Review (Ur) The team lead for utilization review (ur) is responsible for ... Work with manager to establish and track metrics, data and initiatives that improve process * Ur ...
This role focuses on early identification of patient needs, care coordination, utilization management, and safe transitions of care to ensure high-quality, cost-effective outcomes while supporting ...
This role focuses on early identification of patient needs, care coordination, utilization management, and safe transitions of care to ensure high-quality, cost-effective outcomes while supporting ...
Hartford, CT · On-site
$34.25 - $46.50/hr
The Team Lead for Utilization Review (UR) is responsible for the day-to-day activities and ... Case Management Certification. Knowledge, Skills and Abilities: Knowledge: * Demonstrate working ...
Hartford, CT · On-site
$34.25 - $46.50/hr
The Team Lead for Utilization Review (UR) is responsible for the day-to-day activities and ... Case Management Certification. Knowledge, Skills and Abilities: Knowledge: * Demonstrate working ...
Must Have Skills Payer-provider integration workflows Authorization processes Provider data exchange Eligibility verification Utilization management Claims adjudication & provider workflows Health ...
Must Have Skills Payer-provider integration workflows Authorization processes Provider data exchange Eligibility verification Utilization management Claims adjudication & provider workflows Health ...
Candidate with previous experience with utilization management and managed care. Excellent written and verbal communication skills and patient assessment skills required. Preferred Qualifications
Candidate with previous experience with utilization management and managed care. Excellent written and verbal communication skills and patient assessment skills required. Preferred Qualifications
$39.3K - $50.7K
15% of jobs
$50.7K - $62K
8% of jobs
$63.7K is the 25th percentile. Wages below this are outliers.
$62K - $73.4K
15% of jobs
The median wage is $80.6K / yr.
$73.4K - $84.8K
20% of jobs
$84.8K - $96.1K
11% of jobs
$101.8K is the 75th percentile. Wages above this are outliers.
$96.1K - $107.5K
13% of jobs
$107.5K - $118.9K
5% of jobs
$118.9K - $130.2K
3% of jobs
$130.2K - $141.6K
4% of jobs
$141.6K - $153K
3% of jobs
$153K - $164.3K
3% of jobs
$39.3K
$90.2K
$164.3K
A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.
As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.
To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.
The top searched job categories for Utilization Management jobs in Wethersfield, CT are:
Cities near Wethersfield, CT with the most Utilization Management job openings:
$60/hr
Other
Re-posted 24 days ago
Hamden, Connecticut, United States Or refer someone Job Openings RN Utilization Management - $60/hr - Hamden, CT
About the Job RN Utilization Management - $60/hr - Hamden, CTJob Title: RN Utilization Management (UM)
Pay Rate: $60.00/hr
Contract Weeks: 12
Shift: 3:00 PM - 11:30 PM
Guaranteed Hours: 40
Location: Hamden, CT
Requirements:
Description: We are looking for a dedicated RN with Utilization Management experience for a 12-week contract in Hamden, CT. The ideal candidate will have a strong understanding of UM practices and be able to work effectively in a fast-paced environment.
To Apply: please email your resume to jobs@mercurygroupstaffing.com and text (267) 209-3262 to schedule an interview.
Job ID: CS 8097419, 8097420, 8097421
