- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... 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 - ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide… more
- Beth Israel Lahey Health (Boston, MA)
- …taking a job, you're making a difference in people's lives.** The RN Case Manager working in the Triad Model of Care Transitions partners with the interdisciplinary ... patient. Together with the medical provider, the RN Case Manager collaborates with all members of the care team,...of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a… more
- CVS Health (Boston, MA)
- …it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating all case ... business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management Certification **Education** Associate Degree… more
- Fresenius Medical Center (Lowell, MA)
- …supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... of maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line.… more
- Commonwealth Care Alliance (Boston, MA)
- …that require intensive care management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an interdisciplinary ... 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
- 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 ... reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts,...If you're unable to resolve a situation, find a manager who can. **9. Protect confidentiality and privacy:** It's… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Qualifications:** 1. Bachelor's degree preferred. 2. Current Massachusetts state license as a Registered Nurse (RN). 3. Two years of recent acute hospital ... care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning… more
- Beth Israel Lahey Health (Burlington, MA)
- …to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure, ... Standards of Practice and Code of Ethics, the Case Manager performs duties relative to utilization and...Must hold current Commonwealth of Massachusetts license as a Registered Nurse , and Basic Life Support (BLS)… more
- State of Massachusetts (Boston, MA)
- …have at least (A) two years of full-time, or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility and (B) ... Shattuck Hospital is seeking a dedicated and experienced Case Manager to coordinate key functions within our Case Management...of nursing must have applied for the first available registered nurse examination. Based on assignment, possession… more
- Tufts Medicine (Lowell, MA)
- …(4 Hours)** **Job Description** **Minimum Qualifications:** 1.Current licensure as a Registered Nurse or Physical Therapist. 2. Massachusetts RN Licensure ... **Job Overview** The Clinical Manager - Home Health & Hospice directs, coordinates...Support (BLS) Certification **Preferred Qualifications:** 1. Bachelor's prepared level preferred- Registered Nurse BSN preferred, or Physical Therapist… more
- Beth Israel Lahey Health (Burlington, MA)
- …to ensure a timely process. **Minimum Qualifications:** Education: + Registered Nurse , Bachelors Degree strongly preferred.Licensure, Certification, ... Registration: + Must hold current Commonwealth of Massachusetts license as a Registered Nurse , and Basic Life Support (BLS) Skills, Knowledge & Abilities: In the… more
- Cambridge Health Alliance (Cambridge, MA)
- …: CHA Cambridge Hospital **Work Days** : rotating weekend/ **Category** : Registered Nurse **Department** : Inpatient Case Management CH **Job Type** ... RN Case Manager - Inpatient Case Management CH **Requisition Number:**...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Cambridge Health Alliance (Everett, MA)
- …CHA Everett Hospital **Work Days:** 8-4:30pm including weekend rotation **Category:** Registered Nurse **Department:** Inpatient Case Management Everett **Job ... RN Case Manager - Inpatient Case Management Everett **Requisition Number:**...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …may require evening, weekend and/or holiday shifts on a rotating basis. Job Requirements: + Registered Nurse License in MA + 1-2 years of clinical experience + ... this growth. We are currently hiring a Clinical Care Manager based in Framingham, MA. The Clinical Care ...patient engagement, reduce risk, and minimize hospital and ER utilization . + Identifies, manages, and coordinates patient care, providing… more
- Tufts Medicine (Boston, MA)
- Case Manager , RN - Full-Time Tufts Medical Center is...in Nursing. 2. Basic Life Support (BLS) Certification. 3. Registered Nurse (RN) License. 4. Three (3) ... by unit, across the continuum of care. The Case Manager works to achieve daily clinical, quality and cost...and team members and discusses the appropriateness of resource utilization , consults and treatment plan. 4. Ensures that the… 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 * ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...management team, shared accountability for reductions in acute care utilization * Attend team meetings and huddles to provide… 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 ... this growth. We are currently hiring a Clinical Care Manager - OBAT RN based in Framingham. As part...self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and… more
- Brockton Hospital (Brockton, MA)
- …preferred. Must have current license from Commonwealth of Massachusetts to practice as a Registered Nurse . Minimum of five years clinical experience in an acute ... guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as the primary liaison...care facility required. Prior experience in case management, utilization review or discharge planning… more
- Deloitte (Boston, MA)
- …clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN, Quality, ... degree in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist… more
