- Milford Regional Medical Center (Milford, MA)
- …services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization ... 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 (Burlington, MA)
- …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
- Beth Israel Lahey Health (Burlington, MA)
- …40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- Lincoln Financial Group (Boston, MA)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Elevance Health (Woburn, MA)
- …medical decisions to members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review , of Medical Oncology ... regimens and supportive care. + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Baystate Health (Greenfield, MA)
- …Smoothly adjusts to temporary increases in workload. Assists in maintaining Utilization Review /Appeals and Denials documents to reflect current workflow. ... experience-Case Management experience **Preferred Work Experience:** **1)** Experience in utilization review process **Skills and Competencies:** **1)** Ability… more
- Beth Israel Lahey Health (Cambridge, MA)
- …lives.** Job Description Job Description Primary Responsibilities 1. The emergency nurse initiates accurate and ongoing assessment of physical, psychological and ... focused subjective and objective data through history taking, physical examination, review of records and communication with health care providers, significant… more
- Baystate Health (Springfield, MA)
- **Position** Licensed Practical Nurse **SCHEDULE:** + Full time + Monday - Friday + No weekends no holidays **LOCATION** : + Springfield, MA The Licensed Practical ... Nurse (LPN) functions under the supervision and guidance of...support to the patient's primary care team regarding patients' utilization management needs. The Clinical Utilization Reviewer… more
- Elevance Health (Woburn, MA)
- ** Nurse Audit Lead** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Description:** **Primary Responsibilities** (including but not limited to): 1. Performs utilization review and discharge planning to inpatient admissions to ... with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient… more
- Universal Health Services (South Attleboro, MA)
- …team and identifying patient treatment needs, medication assessments and adjustments, and utilization review support as needed. Fuller Hospital is a 109-bed ... Responsibilities Psychiatric Nurse Practitioner Opportunity Fuller Hospital is seeking a...leaders that educate the field, routinely exchange ideas, and review current topics within the industry. Having the opportunity… more
- Beth Israel Lahey Health (Needham, MA)
- …clinical leader to bring best clinical practice to the bedside. The nurse manager provides 24-hour operational accountability for their unit(s). Collaborates with ... improvement activities to enhance patient care and improve service. Additionally, the Nurse Manager participates in the development of and implementation of care and… more
- State of Massachusetts (Marlborough, MA)
- …within Massachusetts nursing homes, hospitals and other health care facilities, and review inspection findings. The Health Care Facility Surveyor will play a vital ... in order to determine the degree of acceptance and utilization of health care, type and breadth of service,...3-5 years of professional work experience as a Registered Nurse working in a health care facility, preferably nursing… more
- Beth Israel Lahey Health (Wakefield, MA)
- …Working with the healthcare team, the Care Manager, RN monitors appropriate utilization of healthcare resources, promotes quality and efficiency by developing and ... management by focusing care coordination attention on the at-risk population driving utilization and costs to improve efficiency, quality and patient satisfaction. +… more
- Fallon Health (Springfield, MA)
- …of all services provided according to professional standards + Identifies utilization and service delivery problems and participates in identifying a resolution ... activities including but not limited to record reviews, outcome measurement and review /revision of policies and procedures + Provides education and training to… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... point-of-care testing, treatments, and lab and diagnostic test result review + Documents patient care, ongoing evaluation, patient progress/risk status,… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... medication reconciliation, point-of-care testing, treatments, and lab and diagnostic test result review + Provides timely and informed patient triage + Involves the… more
- Trinity Health (Springfield, MA)
- …Nursing BSN degree preferred. + **Experience:** 3-5 years in Case Management, Utilization review , or similar experience preferred. Hospital or community-based ... program. BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS (AHA/ARC). CCM or ACM… more
- Trinity Health (Springfield, MA)
- …preferred. **Preferred Skills:** + **Experience:** 3-5 years in Case Management, Utilization review , or similar experience preferred. Hospital or community-based ... program. BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS (AHA/ARC). CCM or ACM… more
- Fresenius Medical Center (West Springfield, MA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more