- Cognizant (Boston, MA)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...an impact by performing advanced level work related to clinical denial management and managing clinical denials… more
- Beth Israel Lahey Health (Plymouth, MA)
- …job that may reasonably be required._ **Education/Experience Required:** _Required_ + State of MA Registered Nurse (RN) + 3-5 years acute care nursing + Two ... patient and family/caregiver. Facilitates smooth care transitions by ensuring appropriate clinical follow-up is arranged and referrals to proper post-acute providers… more
- Beth Israel Lahey Health (Burlington, MA)
- …of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case managers analyze ... of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case managers analyze… 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 ... improve the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet… more
- Cambridge Health Alliance (Somerville, MA)
- …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job ... **This position in onsite in Somerville** Department Description: Utilization review ( UR ) in behavioral health that evaluates the medical necessity of service… more