- Cognizant (Boston, MA)
- …need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… 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
- Beth Israel Lahey Health (Boston, MA)
- …related duties as required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical ... vs. outpatient) based on medical necessity. 3. Actively seeks additional clinical documentation from the physician to optimize hospital reimbursement when… 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 ... team to assess and improve the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding… more
- Brockton Hospital (Brockton, MA)
- …primary responsibilities. EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It ... include the development and supervision of staff (RNs, LPN's,SWs and non- clinical support), evaluation and maintenance of case management skills and outcomes,… more