- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets… more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the ... severity of an array illnesses, intensity of service, and care coordination needs + Ability to identify appropriateness of patients admission and level of care needs (inpatient & observation) utilizing Interqual criteria + Knowledge of Interqual required;… more
- US Tech Solutions (Canton, MA)
- …required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- that is expected to function independently in her / his ... of clinical decision making and support needed to perform utilization management, medical necessity determinations and benefit determinations using applicable… more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the ... severity of an array illnesses, intensity of service, and care coordination needs + Ability to identify appropriateness of patients admission and level of care needs (inpatient & observation) utilizing Interqual criteria + Knowledged of Interqual required;… more
- Commonwealth Care Alliance (Boston, MA)
- …is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting ... 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA)...reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison… more
- Amergis (Canton, MA)
- Salary: $3595 / Week Amergis Healthcare is seeking an experienced Registered Nurse and self-motivated individual to provide data collection and related activities ... for Quality Improvement (QI) and Utilization Review as well as completion of financial documents...care, billing, and reimbursement processes. For this role, the nurse will be adding Admissions and Insurance Authorizations. MUST… more
- Children's Hospital Boston (Boston, MA)
- …Title:Per Diem RN Case Manager, Utilization Management/ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard Hours per ... of payer denials. They identify and implement initiatives to manage utilization trends, collaborating with the hospital's discharge planning case managers,… 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 Nurse ... care to individuals, families, communities, and patient populations. The Registered Nurse 's care delivery is consistent with the Massachusetts Board of Registration… more
- CVS Health (Boston, MA)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC recognized accreditation… more
- CVS Health (Boston, MA)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in...lower levels of care. + 1+ years' experience in Utilization Review. + CCM and/or other URAC recognized accreditation… more
- Atrius Health (Braintree, MA)
- …value-based care system in the country. *_SUMMARY_*__ Physician Assistant/ Nurse Practitioner (MNA) position supporting our Orthopedics department. The Physician ... Assistant/ Nurse Practitioner will work collaboratively on a team to...care in Specialty. Demonstrated excellence in practice, documentation and utilization . Maintain high patient satisfaction. Ability to work effectively… more
- Commonwealth Care Alliance (Boston, MA)
- …intensive care management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an interdisciplinary team for medical ... on the fluctuating needs of the defined panel of members, the Registered Nurse will engage in regular assessments, visits at regularly scheduled intervals, and… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part-Time Flex Evenings, Emergency Signature Healthcare's Brockton Hospital is hiring for a Part-Time Flex Evenings Registered Nurse (RN) ... commitment to comprehensive patient care. Under the guidance of a Charge nurse , our team emphasizes efficient throughput, flexibility, and autonomy in initiating… more
- Brockton Hospital (Brockton, MA)
- Periop-101/Transition to Practice OR Nurse Signature Healthcare's Brockton Hospital is hiring Full time Registered Nurse (RN)'s for a Periop-101/Transition to ... will be required to fulfill call requirements with a 30-minute response time. Registered Nurse (RN) Roles and Responsibilities: Specific Duties: + The Nurse will… more
- Atrius Health (Easton, MA)
- …the direction of the department chief, the incumbent is a certified nurse practitioner (NP) who possesses advanced training/skills in assessing, diagnosing, and ... Serves as a patient educator in areas of specialization. *_EDUCATION/LICENSES/CERTIFICATIONS_* * Nurse Practitioner (NP) *- Must be nationally certified as an FNP… 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) for ... off-shifts to enhance patient care, staffing, and throughput coordination. Registered Nurse (RN) Roles and Responsibilities: + Assessment: collects relevant patient… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Job, Part-time Flex Nights, Resourse Nurse Signature Healthcare's Brockton Hospital is hiring a Part-time Flex Registered Nurse (RN) ... patient care, supported by clinical care assistants on all shifts. Registered Nurse (RN) Roles and Responsibilities: + Assessment: collects relevant patient health… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), J ob, (Very Specific Shift-Type) , (Department/Unit) Signature Healthcare's Brockton Hospital is hiring for a (shift type) Registered Nurse ... stronger than ever. Insert Department/Unit Insert Department/Unit Description Registered Nurse (RN) Roles and Responsibilities: + Assessment: collects relevant… more
- Brockton Hospital (Brockton, MA)
- …and health of our patients. Position Summary: Purpose of Position: The Registered Nurse provides nursing care to assigned patients newborn to geriatric according to ... of the Department of Nursing and in compliance with Massachusetts Nurse Practice Act. Independent Action: Functions independently within established department… more
- Brockton Hospital (Brockton, MA)
- …health of our patients. Position Summary: Purpose of Position : The Registered Nurse provides nursing care to assigned patients newborn to geriatric according to the ... of the Department of Nursing and in compliance with Massachusetts Nurse Practice Act. Independent Action : Functions independently within established department… more