- Albany Medical Center (West Stockbridge, MA)
- …Shift:Day (United States of America)Salary Range:$83,200.00 - $128,960.00Urogynecology Nurse (RN)Division of Urogynecology within the Department of Ob/GynLocation: ... environment centered on efficient, compassionate patient care.The Urogynecology RN is a nurse who delivers proficient care for women with pelvic floor disorders… more
- Albany Medical Center (West Stockbridge, MA)
- …the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may provide ... and pharmacy renewals; facilitates call-backs to patients as necessaryFacilitates the utilization of resources to meet patient outcomes and contribute to Facility… more
- Albany Medical Center (West Stockbridge, MA)
- …States of America)Salary Range:$83,200.00 - $128,960.00Salary range: $33/hr. - $47.60/hr.Registered Nurse (RN) - Full TimeHIV Medicine Clinic - Albany, NYWe have ... the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may provide… more
- Albany Medical Center (West Stockbridge, MA)
- …the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may provide ... and pharmacy renewals; facilitates call-backs to patients as necessaryFacilitates the utilization of resources to meet patient outcomes and contribute to Facility… more
- 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 (MA)
- …we do it all with heart, each and every day. Requisition Job Description Utilization Management is a 24/7 operation and work schedule may include weekends and ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more
- Beth Israel Lahey Health (Boston, MA)
- …lives.** Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status ... of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for… more
- Cognizant (Boston, MA)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical… 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
- Beth Israel Lahey Health (Burlington, MA)
- …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management team ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
- Lawrence General Hospital (Lawrence, MA)
- …referrals and facilitates appropriate discharge plans. + Works in conjunction with Utilization Review Nurse , Social Worker and Clinical Care Leader to ... As the Complex Care Nurse Manager provides evidence-based assessments, tools, information, and...setting with discharge planning, continuing care, care management, and utilization review. + Five years clinical nursing experience required… more
- Lincoln Financial (Boston, MA)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. + 2 years' experience as a Utilization Management/Prior Authorization nurse in a managed care payer preferred. + One ... Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The PA Nurse uses a multidisciplinary approach to review service requests (prior-authorizations),… more
- Bear Mountain Health Care (Worcester, MA)
- …accurate bills to residents, families, responsible parties. * Communicates regularly with Utilization Review Nurse , Admissions and Social Services to maintain ... accurate billing information. * Reconcile Personal Needs Account bank statements, ensure withdrawal and deposits are processed daily, and quarterly statements are mailed, and complete annual reconciliation for resident Personal Needs Accounts. * Committed to… more
- Elevance Health (Woburn, MA)
- ** Utilization Management Representative II** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... shift between 8 am - 8 pm EST. The ** Utilization Management Representative II** is responsible for managing incoming...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… 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 Nurse ... care to individuals, families, communities, and patient populations. The Registered Nurse 's care delivery is consistent with the Massachusetts Board of Registration… more
- Beth Israel Lahey Health (Cambridge, MA)
- …with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient ... Description:** **Primary Responsibilities** (including but not limited to): 1. Performs utilization review and discharge planning to inpatient admissions to MAH. 2.… more
- Fallon Health (Worcester, MA)
- …follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Custodial Nurse Case Manager (NCM) is a key member of the Clinical Integration Team, ... including behavioral and rehabilitative services. **Responsibilities** **Primary Job Responsibilities** ** Utilization Review and Care Coordination and Collaboration** + Clinical… more
