- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- Beth Israel Lahey Health (Plymouth, MA)
- …the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… more
- Baystate Health (Springfield, MA)
- …Minimum - Midpoint - Maximum $96,137.00 - $110,510.00 - $130,728.00 The Hospital Case Manager is a registered nurse responsible for the coordination of ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- Beth Israel Lahey Health (Boston, MA)
- …taking a job, you're making a difference in people's lives.** The RN Case Manager working in the Triad Model of Care Transitions partners with the interdisciplinary ... patient. Together with the medical provider, the RN Case Manager collaborates with all members of the care team,...of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a… more
- CVS Health (Boston, MA)
- …it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating all case ... business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management Certification **Education** Associate Degree… more
- Fresenius Medical Center (Fairhaven, MA)
- …supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... of maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line.… more
- Commonwealth Care Alliance (Boston, MA)
- …that require intensive care management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an interdisciplinary ... and based on the fluctuating needs of the defined panel of members, the Registered Nurse will engage in regular assessments, visits at regularly scheduled… more
- Baystate Health (Springfield, MA)
- …a Magnet Hospital for Nursing Excellence is looking for a medical telemetry inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... **Certifications:** Basic Life Support - American Heart AssociationAmerican Heart Association, Registered Nurse - State of MassachusettsState of Massachusetts… more
- Baystate Health (Springfield, MA)
- …(BMC), a Magnet Hospital for Nursing Excellence is looking for a medical inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... **Certifications:** Basic Life Support - American Heart AssociationAmerican Heart Association, Registered Nurse - State of MassachusettsState of Massachusetts… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by leading the ... reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts,...If you're unable to resolve a situation, find a manager who can. **9. Protect confidentiality and privacy:** It's… more
- North Shore Community Health (Gloucester, MA)
- …Primary Care Team Nurse Care Manager (PC team RN CM) is a registered nurse whose primary responsibility is managing a panel of patients on an assigned ... Primary Care Team Nurse Care Manager Gloucester, MA (http://maps.google.com/maps?q=302+Washington+Street+Gloucester+MA+USA+01930)...Perform nurse visits independently and within the registered nurse scope of practice outlined by… more
- Baystate Health (Springfield, MA)
- …- American Heart AssociationAmerican Heart Association, Driver License - OtherOther, Registered Nurse - State of MassachusettsState of Massachusetts **Equal ... employees. Minimum - Midpoint - Maximum $87,859.00 - $100,984.00 - $119,412.00 **RN, ACO Nurse Care Manager , Community Health Center** The **ACO Nurse Care… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Qualifications:** 1. Bachelor's degree preferred. 2. Current Massachusetts state license as a Registered Nurse (RN). 3. Two years of recent acute hospital ... care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning… more
- Beth Israel Lahey Health (Burlington, MA)
- …to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure, ... Standards of Practice and Code of Ethics, the Case Manager performs duties relative to utilization and...Must hold current Commonwealth of Massachusetts license as a Registered Nurse , and Basic Life Support (BLS)… 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 ... summer and one winter holiday. **Job Description:** The Emergency Department Case Manager is responsible and accountable for patient trajectory by assisting the… more
- Baystate Health (Springfield, MA)
- …to this role. **Education:** Bachelors Degree in Nursing (Required) **Certifications:** Registered Nurse - State of MassachusettsState of Massachusetts **Equal ... $46.22 - $53.13 - $62.85 **RN, Patient Placement Bed Manager - Per Diem** **8 or 12 hour shifts** +...identify level of care, potential need for practice guideline utilization , to determine the anticipated LOS and anticipated care… more
- State of Massachusetts (Boston, MA)
- …have at least (A) two years of full-time, or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility and (B) ... Shattuck Hospital is seeking a dedicated and experienced Case Manager to coordinate key functions within our Case Management...of nursing must have applied for the first available registered nurse examination. Based on assignment, possession… more
- CenterWell (Pittsfield, MA)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... at our Pittsfield, MA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Tufts Medicine (Lowell, MA)
- …(4 Hours)** **Job Description** **Minimum Qualifications:** 1.Current licensure as a Registered Nurse or Physical Therapist. 2. Massachusetts RN Licensure ... **Job Overview** The Clinical Manager - Home Health & Hospice directs, coordinates...Support (BLS) Certification **Preferred Qualifications:** 1. Bachelor's prepared level preferred- Registered Nurse BSN preferred, or Physical Therapist… more
- Point32Health (MA)
- …Qualifications - what you need to perform the job Certification and Licensure + Registered Nurse with current unrestricted license in state of residence + May ... wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager possesses strong clinical knowledge, critical… more