- Cognizant (Boston, MA)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Beth Israel Lahey Health (Boston, MA)
- … Registered Nurse (RN), Massachusetts + Three years of recent clinical or utilization management experience _Preferred:_ + Bachelor's degree in nursing or ... applying the principles, methods, materials, and equipment necessary in providing utilization management services. Demonstrates clinical expertise to effectively… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... responsible for day-to-day timely clinical and service authorization review for medical necessity and...service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key… more
- Beth Israel Lahey Health (Plymouth, MA)
- …establish the appropriate level of care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review, evaluate, and appeal clinical ... degree in healthcare preferred. + Three years recent, broad clinical experience in the hospital setting + Experience with... experience in the hospital setting + Experience with utilization management within the last 3 years required +… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Commonwealth Care Alliance (Boston, MA)
- …in primary care or care management, including: + 5+ years' experience as Registered Nurse in a high touch clinical environment or home care + AND + 2+ ... management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral...and social needs. The RN uses evidenced-based care approaches, clinical skills, education, and training to influence the … more
- Fenway Health (Boston, MA)
- Registered Nurse Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Full-time Description As a Registered ... and efficient care to individuals, families, communities, and patient populations. The Registered Nurse 's care delivery is consistent with the Massachusetts… more
- CVS Health (Boston, MA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part- Time Flex Nights, A2-Telemetry Signature Healthcare's Brockton Hospital is hiring for a Part Time Flex Registered Nurse (RN) ... during off-shifts to enhance patient care, staffing, and throughput coordination. Registered Nurse (RN) Roles and Responsibilities: + Assessment: collects… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part-Time Flex Nights, Emergency Signature Healthcare's Brockton Hospital is hiring a Part-Time Flex Overnights Registered Nurse ... care, supported by recent additions of paramedics and LPNs. Registered Nurse (RN) Roles and Responsibilities: +...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization :… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part-Time, Flex, Nights, 8 Hour Shift, Telemetry Signature Healthcare's Brockton Hospital is hiring for a Part-Time, Flex, 8 Hour Shift, ... Registered Nurse (RN) for Telemetry in Brockton,...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization :… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part-Time Flex, 12-hour Day Shift, A5 Medical-Surgical Unit Signature Healthcare's Brockton Hospital is hiring for a Part-Time Flex, ... 12-Hour Day Shift, Registered Nurse (RN) for the A5 Medical-Surgical...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization :… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Full Time Flex...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization : ... Brockton Hospital is hiring for a Full Time Flex, Evenings & On Call, Registered Nurse (RN) for Operating Room in Brockton, MA. Type: Full Time Flex Shift:… more
- Atrius Health (Easton, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... health and welfare benefit package. **Job:** **Nursing* **Organization:** **Family Practice* **Title:** * Registered Nurse (MNA) Family Medicine - Easton - Full… more
- Atrius Health (Dedham, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Dedham - Full… more
- Atrius Health (Dedham, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Dedham - 40HRS*… more
- Atrius Health (Boston, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... health and welfare benefit package. **Job:** **Nursing* **Organization:** **Endocrinology* **Title:** * Registered Nurse (MNA) Endocrinology - Kenmore - Part time… more
- Atrius Health (Boston, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... health and welfare benefit package. **Job:** **Nursing* **Organization:** **Nephrology* **Title:** * Registered Nurse (MNA) Nephrology - Kenmore - Per diem*… more
- Beth Israel Lahey Health (Cambridge, MA)
- …high reliability processes to reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...outliers, compiling reports and serving as the liaison with clinical stakeholder and clinical committees in sharing… more
- Beth Israel Lahey Health (Cambridge, MA)
- …**Required Qualifications:** 1. Bachelor's degree preferred. Current state license as a Registered Nurse . 2. Three years of medical/surgical nursing care ... with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient… more