- Milford Regional Medical Center (Milford, MA)
- …to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization management at ... of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria 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
- Beth Israel Lahey Health (Burlington, MA)
- …in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based ... 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
- CVS Health (Boston, MA)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
- CVS Health (Boston, MA)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with...zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required +… more
- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in Burlington ... Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates… more
- Humana (Boston, MA)
- …Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards knowledge is… more
- State of Massachusetts (Boston, MA)
- …Massachusetts Department of Public Health (DPH), is seeking a skilled Screening Nurse Liaison to oversee patient admissions. This role involves assessing prospective ... smooth transitions into the facility. Acting as the primary liaison, the nurse will collaborate with case managers, social workers, physicians, and professional… more
- Veterans Affairs, Veterans Health Administration (Bedford, MA)
- Summary Registered Nurse -Inpatient CLC positions at the Bedford Healthcare System. This position is full-time 40 hours per week. This is an open continuous ... as vacancies become available. This OCA may be used to fill a Registered Nurse (RN) position that is located in the one of following services and specialties:… more
- Fenway Health (Boston, MA)
- Registered Nurse , Part-Time Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Part-time Description As a Registered ... Nurse (RN) at Fenway Health you will provide compassionate,...patient, and other care team members. + Influences appropriate utilization of healthcare resources by helping to coordinate patient… more
- Evolent (Boston, MA)
- …Stay for the culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management staff,… more
- Veterans Affairs, Veterans Health Administration (West Roxbury, MA)
- Summary This Registered Nurse - 2N position is within the Nursing service at the West Roxbury location. This is a full-time position at 40 hours per week. ... Responsibilities Registered Nurse duties will include, but are not limited to,...education, orientation, competencies and providing quality improvement and outcomes utilization . Partners with the patient, family, and interdisciplinary team… more
- Evolent (Boston, MA)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact as part of ... focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies and procedures… more
- Atrius Health (Peabody, MA)
- …the direction of the department chief, the incumbent is a certified nurse practitioner (NP) who possesses advanced training/skills in assessing, diagnosing, and ... *_EDUCATION/LICENSES/CERTIFICATIONS_* Graduate of a State-approved school of Nursing and Nurse Practitioner program. Master of Science degree and Nurse… more
- Atrius Health (Braintree, MA)
- …value-based care system in the country. *_SUMMARY_*__ Physician Assistant/ Nurse Practitioner (MNA) position supporting our Orthopedics department. The Physician ... Assistant/ Nurse Practitioner will work collaboratively on a team to...care in Specialty. Demonstrated excellence in practice, documentation and utilization . Maintain high patient satisfaction. Ability to work effectively… more
- Baystate Health (Springfield, MA)
- **RN, ACO Nurse Care Manager, Community Health Center** The **ACO Nurse Care Manager i** s responsible for the management of care for a defined group of patients ... required and is vital. Care management program metrics including, emergency room utilization , and hospital admission/readmission data will be reviewed on a regular… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part-Time Flex Evenings, Emergency Signature Healthcare's Brockton Hospital is hiring for a Part-Time Flex Evenings Registered Nurse (RN) ... commitment to comprehensive patient care. Under the guidance of a Charge nurse , our team emphasizes efficient throughput, flexibility, and autonomy in initiating… more
- Baystate Health (Springfield, MA)
- **Licensed Practical Nurse (LPN), Inpatient Medical Telemetry Unit** Baystate Health, a nationally recognized leader in healthcare quality and safety, and home to ... Excellence is looking for a medical inpatient Licensed Practical Nurse to join our team in Springfield, MA. A...tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is dedicated to professional growth… more
- Brockton Hospital (Brockton, MA)
- Periop-101/Transition to Practice OR Nurse Signature Healthcare's Brockton Hospital is hiring Full time Registered Nurse (RN)'s for a Periop-101/Transition to ... will be required to fulfill call requirements with a 30-minute response time. Registered Nurse (RN) Roles and Responsibilities: Specific Duties: + The Nurse will… more
- Sharecare (Boston, MA)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is ... To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and objectives of the… more