- 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
- Commonwealth Care Alliance (Boston, MA)
- …have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR ... on site in our Boston clinic and will assume the primary responsibility for clinical operations. If you enjoy working with a collaborative team, striving for the… more
- Teleflex (Boston, MA)
- …territory. The incumbent is responsible for the growth of overall product utilization within their accounts; including, but not limited to, selling the designated ... gain new business. - Facilitate sales growth by conducting physician, nurse , and technologist training and account in-servicing of Interventional Capital products.… more
- 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
- 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
- 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 ... degree in healthcare preferred. + Three years recent, broad clinical experience in the hospital setting + Experience with... experience in the hospital setting + Experience with utilization management within the last 3 years required +… 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
- Fresenius Medical Center (Fairhaven, MA)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… 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 (Easton, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... and welfare benefit package. **Job:** **Nursing* **Organization:** **Family Practice* **Title:** * Registered Nurse (MNA) Family Medicine - Part time 30HRS*… more
- Atrius Health (Cambridge, 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 - Cambridge - Full… more
