- Novo Nordisk Inc. (Boston, MA)
- …sales volume Utilize discretionary budget for maximum impact on sales Clinical Understanding Deep understanding of cardiometabolic disease state and patient ... Inform health system decision makers, influencers and stakeholders hospital faculty, medical students, residents, interns as well as attending physicians, nurse… more
- Evolent (Boston, MA)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible… more
- Elevance Health (Woburn, MA)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for...reviews that are routine having limited or no previous medical review experience requiring guidance by more… more
- Children's Hospital Boston (Boston, MA)
- …of experience in hospital surgery, surgical clinics, surgical clinical research, or medical records + Clinical chart review and abstraction experience ... 82669BRJob Posting Title:Surgical Clinical Reviewer (20 hours/week)Department:Patient Services-Patient Care...to clinical teams. Key Responsibilities + Perform clinical review of surgical cases to support… more
- Fresenius Medical Center (Lowell, MA)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Dana-Farber Cancer Institute (Boston, MA)
- …for a non-oncology area, eg infection control) and the process of conducting medical clinical research. In addition, the CRN utilizes evidence-based nursing ... The Research Nurse in collaboration with the physician, is responsible...physician, is responsible for the implementation and evaluation of clinical research in their specific program/area. The CRN has… more
- Elevance Health (Woburn, MA)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Clinical Fraud Investigator II** is responsible… more
- BAYADA Home Health Care (Wilmington, MA)
- …DCO to ensure cohesive and consistent management of all field staff. + Review all clinical documentation to ensure consistent, accurate, high-quality services. + ... BAYADA Home Health Care is seeking a Registered Nurse (RN) to fill the position of **Home...holidays, vacation and sick leave. + Vision, dental and medical health plans. + Employer paid life insurance, 401k… more
- Humana (Boston, MA)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Beth Israel Lahey Health (Burlington, MA)
- … necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized case ... of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity,...staff on best practices to ensure reimbursement based on medical care provided. 11. Maintains and reports clinical… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Qualifications:** 1. Bachelor's degree preferred. Current state license as a Registered Nurse . 2. Three years of medical /surgical nursing care experience. Two ... (MAH) is a 200-bed acute care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates… more
- Tufts Medicine (Boston, MA)
- …practice and/or best practices. The professional registered nurse at Tufts Medical Center provides clinical excellence, which fosters and supports an ... In addition, this role focuses on performing the following Clinical Nurse duties: Assesses, plans, implements, and...review of the Nursing Executive Council). 2. Registered Nurse (RN) license. 3. Basic Life Support (BLS) certification.… more
- Beth Israel Lahey Health (Cambridge, MA)
- …reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret data, and implement ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...state and federal regulators, insurance appeals, internal correspondence, and clinical summaries for medical peer review… more
- Fresenius Medical Center (Roxbury, MA)
- …12 weeks of paid & structured training with an assigned Preceptor & Nurse Educator** + 70,000+ dedicated employees, 200,000+ patients, 2,600+ dialysis centers, 350+ ... of the hemodialysis health care team as a Registered Nurse Applicant under the direction or supervision of a...transcribes and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Beth Israel Lahey Health (Cambridge, MA)
- …through the entire course of the treatment journey! **Job Description:** Description: The Medical Oncology Nurse Navigator is a professional registered nurse ... to help overcome healthcare system barriers. Utilizing the nursing process, the Medical Oncology Nurse Navigator provides education and resources to facilitate… more
- Beth Israel Lahey Health (Jamaica Plain, MA)
- …care or family medicine practice and serves as a clinical resource for the medical practice. The Team Nurse provides high quality, direct patient care in a ... delegation of clinical and administrative functions as appropriate to the Medical Assistant (MA) staff. Responsible for educating and training our MA team and… more
- Beth Israel Lahey Health (Watertown, MA)
- …care or family medicine practice and serves as a clinical resource for the medical practice. The Team Nurse provides high quality, direct patient care in a ... delegation of clinical and administrative functions as appropriate to the Medical Assistant (MA) staff. Responsible for educating and training our MA team and… more
- Commonwealth Care Alliance (Boston, MA)
- … experience in primary care or care management, including: + 5+ years' experience as Registered Nurse in a high touch clinical environment or home care + AND + ... CCA's patients incorporates the care of individuals with significant medical , behavioral, and social complexities that require intensive care...and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an… more
- Tufts Medicine (Lowell, MA)
- …healthcare. Ready to grow with us? Tufts Medicine Lowell General Hospital is seeking an **ED Clinical Resource Nurse .** The ED Clinical Resource Nurse is ... for optimal efficiency, productivity and utilization of all resources. The ED Clinical Resource Nurse utilizes the nursing process, leadership skills and… more
