- 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
- CVS Health (Boston, MA)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… 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
- 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 , Per Diem Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Part-time Description As a Registered ... Nurse (RN) at Fenway Health you will provide compassionate,...patient, and other care team members. + Influences appropriate utilization of healthcare resources by helping to coordinate patient… more
- Evolent (Boston, MA)
- …Stay for the culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management staff,… 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
- Atrius Health (Weymouth, MA)
- …the direction of the department chief, the incumbent is a certified Nurse Practitioner (NP) or Physician Assistant (PA) who possesses advanced training/skills in ... 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 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
- Baylor Scott & White Health (Boston, MA)
- **LOCATION:** Remote **SPECIALTY/DEPARTMENT:** Care Management: Case Management Utilization Management Appeals or grievances **SHIFT/SCHEDULE:** Full-time days, ... vary based on position type and/or level **Job Summary** A Registered Nurse in Nursing Professional Development Generalist role uses expertise to enhance healthcare… more
- Atrius Health (Weymouth, MA)
- …the country. *SUMMARY* Under the direction and supervision of a Department Chief, Nurse Leader or designee, this licensed practical nurse provides direct patient ... practical nursing. Possess a current license to practice as a practical nurse in the Commonwealth of Massachusetts.American Heart Association Basic Life Support… 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
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), J ob, Part-Time Flex, Day, 8-hour shift , Relief Nursing - Float Signature Healthcare's Brockton Hospital is hiring for a Part-Time Flex, Day, ... 8-hour shift Registered Nurse (RN) for Relief Nursing - Float in Brockton,...+ Research: uses clinical inquiry in practice + Resource Utilization : considers factors related to safety, effectiveness and cost… more