Utilization review nurse Jobs in Hartford, CT

Nurse Manager Care Coordination & Utilization Management

The Nurse Manager Care Coordination & Utilization Management provides strategic and operational leadership for inpatient care coordination, case management, and utilization management services. This role partners with physicians, hospital leadership, and system stakeholders to ensure high-quality, cost-effective, patient-centered care while optimizing throughput, length of stay, and regulatory compliance.

Key responsibilities include :

• Leading Care Coordination, Case Management, and Utilization Management teams, including staff development, performance management, and engagement
• Promoting evidence-based nursing practice, patient safety, and interdisciplinary collaboration
• Overseeing utilization management processes, level-of-care determinations, concurrent reviews, denials management, and appeals
• Collaborating with Physician Advisors, Finance, Revenue Integrity, Patient Access, and Compliance teams
• Monitoring CMS and payer compliance (IMM / MOON, authorizations, documentation standards)
• Driving patient flow initiatives to support timely admissions, transitions of care, and discharge planning
• Analyzing data, trends, and outcomes to support quality improvement and financial stewardship
• Participating in hospital and system-wide committees and strategic initiatives
• Supporting effective use of EPIC (TogetherCare) and reporting tools

Required qualifications include :

Preferred qualifications include :

Why Join Trinity Health of New England?

Our commitment :

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.