Company Statement
Connecticare is a leading health plan in the state of Connecticut and a subsidiary of EmblemHealth, a health and wellness company that provides insurance plans, primary and specialty care, and wellness solutions. WellSpark is a digital wellness company and national subsidiary of EmblemHealth that offers a full suite of products and solutions to reward people for healthy behaviors.
Care Manager, Utilization Management
Qualifications:
- Associate Degree in Nursing; Bachelor’s preferred.
- RN with an active, unrestricted nursing license (Concurrent Review, Medical Management, etc.)
- LPN with an active, unrestricted nursing license (Prior Authorization, Discharge Planning, Retrospective Review)
- MCG Certification preferred
- 4 – 6 years of clinical experience. (R)
- Managed care experience. (P)
- Post-acute facility experience. (P)
- Care management experience. (P)
- Ability to work weekends and holidays on a rotating schedule. (R)
- Excellent communications skills (verbal, written, presentation, interpersonal). (R)
- Effectively able to screen and stratify members who are appropriate for care management services. (R)
- Ability to: manage a caseload of members in need of care management; and apply the care management process as outlined by the CMSA standards and EH’s policies. (R)
- Ability to make appropriate referrals to internal and external programs that meet the member’s needs. (R)
- Ability to create and execute care management care plans and document per EH’s policies and procedures. (R)
- Ability to speak professionally with all necessary parties associated with the member’s care plan. (R)
Security Disclosure
If you are offered a job from one of the EmblemHealth family of companies that includes ConnectiCare, AdvantageCare Physicians, and WellSpark, the offer confirmation email will come from “HRTalentAcquisition” with the subject line: “Offer of Employment for (job title)” – Please respond online”.
We never ask you to join a Google Hangout, request you to purchase your own equipment or pay to apply. We do not send email from a third-party email service such as Yahoo or Gmail.
Pay Disclosure
A good faith estimate of the compensation range for individuals hired to work for the EmblemHealth Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case’s facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.
EEOC Statement
We are committed to leveraging the diverse backgrounds, perspectives, and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy or related condition, marital status, national origin, disability, protected veteran status or any other characteristic protected by law.