- American Red Cross (Dedham, MA)
- …Sign-On Bonus WHAT YOU NEED TO SUCCEED (Minimum Qualifications ): + Registered Nurse with current state licensure as required. + Two years' experience in ... alleviate human suffering. You can make a difference by volunteering in a position that appeals to you and allows you to use your unique skills and talents. The Red… more
- Beth Israel Lahey Health (Burlington, MA)
- …in the resolution of retrospective reimbursement issues, including appeals , third-party payer certification, and denied cases. Monitors effectiveness/outcomes ... as required and directed. **Qualifications:** Required Licensure as a Registered Nurse (RN), Massachusetts Three years of recent clinical or utilization management… more
- Elevance Health (Woburn, MA)
- …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, of chemotherapy regimens. + Determine medical necessity...a subject matter expert. + Perform first level provider appeals as designated by the client for adverse determinations.… more
- Beth Israel Lahey Health (Boston, MA)
- …data analysis on audit trends, scrubber data, government audit requests, denials/ appeals as well as developing and implementing corrective action plans for ... presentations/training sessions. Develops and administers ongoing physician, fellow and nurse practitioner education training sessions including documentation guidelines, new/revised/deleted… more
- Tarrytown Rehabilitation & Nursing Center (Everett, MA)
- …process for MDS and MMQ vacancies. Qualifications: + Licensed as a Registered Nurse in the State of Massachusetts + Three to Five years of clinical ... knowledge (Medicaid, Medicare) and case management process (prior authorization and appeals ) required + Ability to multi-task and adapt to changing priorities… more
- American Red Cross (Medford, MA)
- …courses in First Aid, CPR/AED, Babysitter's Training, Lifeguard Training, Certified Nurse Aid Training, and other certification courses. American Red Cross Training ... alleviate human suffering. You can make a difference by volunteering in a position that appeals to you and allows you to use your unique skills and talents. The Red… more