- 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)
- …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
- Fresenius Medical Center (Lowell, MA)
- …supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... of maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line.… 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)
- …**Required Qualifications:** 1. Bachelor's degree preferred. Current state license as a Registered Nurse . 2. Three years of medical/surgical nursing care ... care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning… more
- BAYADA Home Health Care (Newton, MA)
- …in Senior Living communities **_._** Are you a solutions-oriented, team-focused ** Registered Nurse or Therapist (Physical Therapist, Physical Therapist ... inspire professional growth. **Qualifications:** + Current MA licensure as a Registered Nurse , Physical Therapist, Physical Therapy Assistant, Occupational… 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
- CenterWell (Boston, MA)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license (RN) with no...volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in… more
- Cambridge Health Alliance (Somerville, MA)
- …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job ... RN Case Manager - Inpatient Case Management SH **Requisition Number:**...Somerville **This position in onsite in Somerville** Department Description: Utilization review (UR) in behavioral health that evaluates the… more
- Cambridge Health Alliance (Everett, MA)
- …CHA Everett Hospital **Work Days:** 8-4:30pm including weekend rotation **Category:** Registered Nurse **Department:** Inpatient Case Management Everett **Job ... RN Case Manager - Inpatient Case Management Everett **Requisition Number:**...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Cambridge Health Alliance (Somerville, MA)
- …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job ... RN Case Manager - Inpatient Case Management SH **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)
- …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 Framingham, MA. The Clinical Care ...patient engagement, reduce risk, and minimize hospital and ER utilization . + Identifies, manages, and coordinates patient care, providing… 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
- 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
- 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
- Dana-Farber Cancer Institute (Brookline, MA)
- …experience is preferred. + **Certification/Licensure/Registration:** + Licensed as a Registered Nurse in the Commonwealth of Massachusetts preferred. ... overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + Monitors email communication to the Drug… more