- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... role. Supervision Exercised: - Assumes responsibility for all nursing ( RN , LPN) and MA roles in the practice. 10...management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide… more
- Beth Israel Lahey Health (Burlington, MA)
- …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management team ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
- Fenway Health (Boston, MA)
- …MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Full-time Description As a Registered Nurse ( RN ) at Fenway Health ... patient, and other care team members. + Influences appropriate utilization of healthcare resources by helping to coordinate patient...+ Education: Associate degree in nursing + Current Massachusetts Registered Nurse ( RN ) license degree… more
- Commonwealth Care Alliance (Boston, MA)
- …complexities that require intensive care management and care delivery. Within the CIC Program, the Registered Nurse ( RN ) serves as an integral member of an ... and based on the fluctuating needs of the defined panel of members, the Registered Nurse will engage in regular assessments, visits at regularly scheduled… more
- Atrius Health (Boston, MA)
- …health and welfare benefit package. **Job:** **Nursing* **Organization:** **Endocrinology* **Title:** * Registered Nurse (MNA) Endocrinology - Kenmore - Part time ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience, ideally in an ambulatory care or Endocrine… more
- Atrius Health (Dedham, MA)
- …. Competitive health and welfare benefit package. **Job:** **Nursing* **Organization:** **ENT* **Title:** * Registered Nurse (MNA) ENT - Dedham - Full time 40HRS* ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience. Experience with an electronic medical records system… more
- Atrius Health (Dedham, MA)
- …and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Dedham - Full ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience. Experience with an electronic medical records system… more
- Atrius Health (Dedham, MA)
- …and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Dedham - 40HRS* ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience. Experience with an electronic medical records system… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by leading the ... on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of...reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts,… more
- Humana (Boston, MA)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the (appropriate state) with no ... our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- CVS Health (Boston, MA)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team.… more
- CVS Health (Boston, MA)
- …health. + Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in clinically… more
- CVS Health (Boston, MA)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
- Gentiva (Auburn, MA)
- …Hospice Administrator to join our leadership team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care, ... Interview, hire, supervise, evaluate, and support interdisciplinary hospice staff including RN Clinical Managers, RNs, LPNs, social workers, chaplains, CNAs, and… more
- Cambridge Health Alliance (Somerville, MA)
- …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job ... RN Case Manager - Inpatient Case Management SH...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Sharecare (Boston, MA)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …require evening, weekend and/or holiday shifts on a rotating basis. Required Qualifications: + Registered Nurse License in MA + Bachelor's degree in Nursing from ... are currently hiring a Clinical Care Manager - OBAT RN based in Framingham. As part of a team-based...self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and… more
- Health Plans, Inc. (Westborough, MA)
- …funding sources as appropriate What you bring + An active professional licensure as a Registered Nurse ( RN ) + 3+ years of clinical experience (required) + ... healthcare system as a whole. In this role, you'll also: + Conduct utilization management using standardized clinical criteria + Consult with Physician Reviewers and… more
- BAYADA Home Health Care (Newton, MA)
- …in Senior Living communities **_._** Are you a solutions-oriented, team-focused ** Registered Nurse or Therapist (Physical Therapist, Physical Therapist ... inspire professional growth. **Qualifications:** + Current MA licensure as a Registered Nurse , Physical Therapist, Physical Therapy Assistant, Occupational… more
