- 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
- Commonwealth Care Alliance (Boston, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide… more
- CVS Health (Woonsocket, RI)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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
- Prime Healthcare (Woonsocket, RI)
- …work experience post-graduation from an accredited school of nursing and a current state Registered Nurse (RN) license. + Minimum of five years acute care ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/233521/ registered - nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)… more
- Fresenius Medical Center (Providence, RI)
- …care pre, during and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques ... and physical structure of the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment in the vascular access… 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
- 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
- Sharecare (Boston, MA)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… 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
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... or designee. Provides coordinated care support to Physician leadership and Clinical Manager (s) of respective services. Makes daily rounds and collaborates with the… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... or designee. Provides coordinated care support to Physician leadership and Clinical Manager (s) of respective services. Makes daily rounds and collaborates with the… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …may require evening, weekend and/or holiday shifts on a rotating basis. Job Requirements: + Registered Nurse License in MA + 1-2 years of clinical experience + ... this growth. We are currently hiring a Clinical Care Manager based in Milford, MA. The Clinical Care ...patient engagement, reduce risk, and minimize hospital and ER utilization . + Identifies, manages, and coordinates patient care, providing… more
- Cambridge Health Alliance (Cambridge, MA)
- …: CHA Cambridge Hospital **Work Days** : rotating weekend/ **Category** : Registered Nurse **Department** : Inpatient Case Management CH **Job Type** ... RN Case Manager - Inpatient Case Management CH **Requisition Number:**...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …require evening, weekend and/or holiday shifts on a rotating basis. Required Qualifications: + Registered Nurse License in MA + Bachelor's degree in Nursing from ... this growth. We are currently hiring a Clinical Care Manager - OBAT RN based in Framingham. As part...self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and… more
- Tufts Medicine (Boston, MA)
- Case Manager , RN - Full-Time Tufts Medical Center is...in Nursing. 2. Basic Life Support (BLS) Certification. 3. Registered Nurse (RN) License. 4. Three (3) ... by unit, across the continuum of care. The Case Manager works to achieve daily clinical, quality and cost...and team members and discusses the appropriateness of resource utilization , consults and treatment plan. 4. Ensures that the… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have): * Meaningful clinical experience including: * 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR * ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...management team, shared accountability for reductions in acute care utilization * Attend team meetings and huddles to provide… more
- Brockton Hospital (Brockton, MA)
- …preferred. Must have current license from Commonwealth of Massachusetts to practice as a Registered Nurse . Minimum of five years clinical experience in an acute ... guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as the primary liaison...care facility required. Prior experience in case management, utilization review or discharge planning… more
- Deloitte (Boston, MA)
- …clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN, Quality, ... degree in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist… more
- Beth Israel Lahey Health (Boston, MA)
- …are not fit for duty. Participates in the evaluation of staff as requested by the nurse manager . + Rounds on the clinical units to assess and address patient ... Nursing Program required. Baccalaureate degree in Nursing strongly preferred. + License Registered Nurse required. + American Heart Association - Basic Life… more
