Utilization Review Nurse
1 week ago
We are seeking a highly skilled Utilization Review Nurse to join our team at The Cigna Group. As a key member of our Appeals and Grievances team, you will play a critical role in ensuring that our members receive the best possible care and support.
Key Responsibilities- Conduct thorough reviews of medical records and other relevant documentation to determine the appropriateness of medical services and treatments.
- Communicate with members, providers, and other stakeholders to gather information and resolve appeals and grievances.
- Apply knowledge of Medicare and Medicaid regulations to make informed decisions and ensure compliance.
- Collaborate with internal teams to develop and implement effective appeal and grievance processes.
- Provide exceptional customer service and support to our members and stakeholders.
- 3-5 years of experience in Medicare Appeals, Utilization Case Management, or Compliance in Medicare Part C.
- Strong knowledge of Medicare and Medicaid regulations, including Local Coverage Determinations and National Coverage Determinations.
- Excellent written and verbal communication skills, with the ability to present complex information in a clear and concise manner.
- Ability to work independently and as part of a team, with a strong focus on customer service and satisfaction.
- Proficient in Microsoft Office products, including Access, Excel, PowerPoint, and Word.
- A competitive annual salary of $68,300 USD, depending on experience and location.
- A comprehensive benefits package, including medical, vision, dental, and well-being and behavioral health programs.
- A 401(k) plan with company match, company-paid life insurance, tuition reimbursement, and paid time off.
- The opportunity to work with a dynamic and growing company that is committed to improving the health and well-being of our members.
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Licensed Practical Nurse
2 weeks ago
Bloomfield, Connecticut, United States Duncaster Inc Full timeJob Title: Licensed Practical Nurse - Assisted LivingJob Summary:Duncaster Inc is seeking a skilled Licensed Practical Nurse to join our Assisted Living team. As a LPN, you will be responsible for providing high-quality care to our residents, working closely with our Director of Assisted Living and Care Management to ensure the best possible...
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Licensed Nursing Professional
1 month ago
Bloomfield, Connecticut, United States Seabury Full timePosition OverviewSeabury is currently seeking qualified candidates for the role of Registered Nurse (RN) within our esteemed skilled nursing and long-term care facilities. The successful applicant will possess at least one year of relevant experience in areas such as rehabilitation, medical-surgical nursing, intensive care, subacute care, or long-term care....
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Medical Director
1 day ago
Bloomfield, Connecticut, United States The Cigna Group Full timeJob SummaryWe are seeking a highly skilled and experienced Medical Director - Radiation Oncology to join our team at Evernorth Health Services, a division of The Cigna Group. As a key member of our organization, you will play a critical role in guiding our company's strategic utilization review decisions and providing medical advice that has a significant...
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Data Entry Specialist
2 weeks ago
Bloomfield, Connecticut, United States Pyramid Consulting, Inc Full timeJob Title: Data Entry RepresentativeWe are seeking a highly skilled Data Entry Representative to join our team at Pyramid Consulting, Inc. This is a 12+ months contract opportunity with long-term potential and is located in a hybrid setting.Job Summary:The successful candidate will be responsible for completing data entry in our Professional and Facility...
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Data Entry Specialist
1 week ago
Bloomfield, Connecticut, United States Pyramid Consulting Full timeJob Title: Data Entry RepresentativeWe are seeking a highly skilled Data Entry Representative to join our team at Pyramid Consulting, Inc. in Bloomfield, CT. This is a 12+ months contract opportunity with long-term potential.Job Summary:The successful candidate will be responsible for completing data entry in our Professional and Facility Access Databases on...
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RN- Transplant Nurse Case Manager
2 weeks ago
Bloomfield, Connecticut, United States The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled RN- Transplant Nurse Case Manager to join our team at The Cigna Group. As a RN- Transplant Nurse Case Manager, you will play a critical role in coordinating and managing the care of our customers with transplant needs.Key ResponsibilitiesCollaborate with customers to create personalized care plans and document...
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Program Technology Specialist
4 weeks ago
Bloomfield, Connecticut, United States Jobs for Humanity Full timeJob Description**Program Assistive Technology Specialist 3****Job Summary:**We are seeking a highly skilled and innovative Program Assistive Technology Specialist 3 to join our team at Jobs for Humanity. As a key member of our multidisciplinary team, you will play a critical role in providing comprehensive assistive technology solutions and services to...
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Program Specialist for Assistive Technology
3 weeks ago
Bloomfield, Connecticut, United States Jobs for Humanity Full timeJob Title: Program Assistive Technology Specialist 3Company Description: Jobs for Humanity is collaborating with Viability to build an inclusive and just employment ecosystem. We support individuals coming from all walks of life.Job Summary:We are seeking a highly skilled Program Assistive Technology Specialist 3 to join our team. As a key member of our...
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Program Specialist for Assistive Technology
2 weeks ago
Bloomfield, Connecticut, United States VIABILITY, Inc Full timeJob DescriptionUnlock the Potential of Assistive Technology and Virtual RealityWe are seeking a highly skilled and motivated individual to join our team as a Program Assistive Technology Specialist 3. In this role, you will have the opportunity to work with a collaborative multidisciplinary team to provide services that align with the mission of Viability,...
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Transplant Nurse Case Manager
1 week ago
Bloomfield, Connecticut, United States The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Transplant Nurse Case Manager to join our team at The Cigna Group. As a key member of our healthcare team, you will play a vital role in coordinating and guiding care for our customers, families, and caregivers.Key ResponsibilitiesCollaborate with customers to create personalized care plans and document them in...
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Production Associate
5 days ago
Bloomfield, Connecticut, United States Campbell Soup Company Full timeJoin Campbell Soup Company as a Production AssociateWe are seeking a highly motivated and detail-oriented Production Associate to join our team at Campbell Soup Company. As a Production Associate, you will play a critical role in ensuring the highest quality products are produced while maintaining a safe and efficient work environment.Key...
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Nurse Case Manager Senior Analyst
2 weeks ago
Bloomfield, Connecticut, United States The Cigna Group Full timeAbout the RoleThis position, the Nurse Case Manager Senior Analyst, plays a critical role in promoting the improvement of health outcomes for members and assisting those experiencing the burdens of illness and injury.Key ResponsibilitiesAssess, plan, implement, coordinate, monitor, and evaluate options and services to meet an individual's health needs within...
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Weekend Night LPN/RN Position
1 week ago
Bloomfield, Connecticut, United States Aveanna Healthcare Full timeJob Title: Weekend Night LPN/RNAveanna Healthcare is seeking dedicated RNs/LPNs for 1:1 homecare. Our team offers flexible schedules, benefits, PTO, and weekly pay. Holidays are not mandated, and hourly rates are based on case specifics.Job Summary:The Licensed Practical Nurse (LPN/LVN) is responsible for providing and documenting skilled nursing care, under...
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Universal Caregiver
1 month ago
Bloomfield, Connecticut, United States Duncaster Inc Full timeJob OverviewAt Duncaster Inc, recognized as a premier community in senior living, we offer a fulfilling career where you can make a significant impact on the lives of others. Our environment is designed to foster meaningful connections and provide rewarding experiences.Position SummaryThe Universal Caregiver plays a vital role within a household team,...
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Assistive Technology Specialist
4 weeks ago
Bloomfield, Connecticut, United States VIABILITY, Inc Full time{"title": "Assistive Technology Specialist", "subtitle": "Join Viability, Inc. in making a difference in the lives of individuals with disabilities.", "content": "At Viability, Inc., we are seeking a highly skilled and dedicated Assistive Technology Specialist to join our team. As an Assistive Technology Specialist, you will play a critical role in providing...
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Plant Operations Director
5 days ago
Bloomfield, Connecticut, United States Campbell Soup Company Full timeJob SummaryWe are seeking an experienced Plant Operations Manager to join our team at Campbell Soup Company. As a key member of our operations team, you will be responsible for managing the entire operations department in a 24/7 production environment. Your primary focus will be on ensuring the safe and efficient production of premium, fresh-baked food...
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Weekend Night LPN/RN Position
1 week ago
Bloomfield, Connecticut, United States Aveanna Healthcare Full timeJob Title: Weekend Night LPN/RNAveanna Healthcare is seeking dedicated RNs/LPNs for 1:1 homecare. Our team offers flexible schedules, benefits, PTO, and weekly pay. Holidays are not mandated, and hourly rates are based on case specifics.Job Summary:The Licensed Practical Nurse (LPN/LVN) is responsible for providing and documenting skilled nursing care, under...
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Clinical Content Analyst
4 days ago
Bloomfield, Connecticut, United States The Cigna Group Full timeClinical Content Internship OpportunityWe are seeking a highly motivated and detail-oriented Clinical Content Intern to join our team at The Cigna Group. As a Clinical Content Intern, you will have the opportunity to work on a variety of projects that will help you develop your skills and knowledge in the field of clinical content.Responsibilities:Conduct...
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IT Project Management Advisor
5 days ago
Bloomfield, Connecticut, United States The Cigna Group Full timeJob Title: IT Project Management AdvisorThe Cigna Group is seeking an experienced IT Project Management Advisor to join our team. As a key member of our IT department, you will be responsible for providing expert content and professional leadership on complex IT Project Management assignments and projects.Key Responsibilities:Manage and direct project teams...
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Process Optimization Specialist
1 week ago
Bloomfield, Connecticut, United States Actalent Full timeJob Title: Process Optimization SpecialistJob Summary:The Process Optimization Specialist will analyze, improve, and maintain all tooling, equipment, and processes within the assigned area. This role will also support the introduction of new products as needed.Key Responsibilities:Develop, document, implement, and sustain manufacturing processes using...