- 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
- 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 (Burlington, MA)
- …the medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized ... the medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized… 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
- CVS Health (Boston, MA)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Boston, MA)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… 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
- 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 Overnight, Emergency Signature Healthcare's Brockton Hospital is hiring for a Part-Time Flex Overnight Registered ... 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), Job, Part-Time Flex, 12-hour Night Shift, A5 Medical-Surgical Unit Signature Healthcare's Brockton Hospital is hiring for a Part-Time ... Flex, 8-hour Night 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 (Boston, MA)
- …to ensure efficient and outstanding quality of care. This registered professional nurse provides practice support to a clinical team, recognizing the patient ... of the Department Chief Physician and Nursing Supervisor, this Registered Nurse position is responsible for effective...duties include high quality phone triage for symptoms and clinical assessments, review of lab and test results, and… 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:** **Pulmonary* **Title:** * Registered Nurse (MNA) Pulmonary - Kenmore - Full 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
- 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
- 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 (Boston, MA)
- …focusing on the delivery of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a safe and ... The RN Case Manager must be adept at driving throughput metrics, clinical effectiveness, and fiscal responsibility. **Job Description:** Essential Functions: The RN… more
- Tufts Medicine (Melrose, MA)
- …to review patient records, analyze data, and identify practice and patient outlier utilization , and gaps in quality measures for weekly practice and medical director ... list. Other duties and responsibilities may be assigned. 1.Collaborates with PHO clinical leadership and conduct root cause analysis to identify rising and… more