- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …true colors to blue. What we need: As an integral part of HMM Quality and Compliance team , the Senior Medicare Clinical Compliance Consultant works ... to Day: + With minimal oversight, leads CMS utilization management related compliance activities including: + Identify and implement new CMS requirements + Monitor,… more
- Fallon Health (Lawrence, MA)
- …product regulatory requirements and Program policies and processes + Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing ... area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare ...Facebook, Twitter and LinkedIn.** **Brief Summary of Purpose:** The Nurse Case Manager (NCM) is an integral part on… more
- Fallon Health (Dartmouth, MA)
- …Opens New Summit Eldercare Site in Dartmouth, MA!!** Quick summary about the Nurse Practitioner position: + Great pay + Great Benefits - including very affordable ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Position Overview:** Manages a… more
- Fallon Health (Leominster, MA)
- …to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that ... by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org. **About… more
- Beth Israel Lahey Health (Reading, MA)
- …staff and clinical care of all patients receiving care at the hospice house. The Nurse Manager is responsible for directing the team in the provision of high ... **When you join the growing BILH team , you're not just taking a job, you're...Shift:** Day (United States of America) The Hospice House Nurse Manager plans and delivers care to patients utilizing… more
- Bear Mountain Health Care (Andover, MA)
- MDS (Minimum Data Set) nurse is a key tool in the process of assessing the functional capabilities of residents of our skilled nursing facilities. This role requires ... a registered nurse (RN) who conducts federally mandated assessments of the...They must also make sure all strategies comply with Medicare and Medicaid requirements and ethical standards. An MDS… more
- Point32Health (MA)
- …nearby cities/towns in Massachusetts* Under the direction of a Senior Manager, the Nurse Practitioner (NP) in the Community and SNF/ Post-Acute Program will see high ... as in collaboration with care management teams and a nurse practitioner rounder. The NP in this role is...education to family and patient to improve understanding and compliance ** **Engage and implement practices that improve continuity of… more
- Fallon Health (Webster, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... care responsibilities to other members of the health care team , when appropriate. + Identifies emergency situations and initiates...+ Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director. + Assumes the… more
- Fallon Health (Springfield, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Position Summary:** Responsible ... care responsibilities to other members of the health care team , when appropriate. + Identifies emergency situations and initiates...to cover multiple departments to include homecare, primary care nurse , triage nurse and floor and treatment… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review ... for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in...has a key role in ensuring CCA meets CMS compliance standards in the area of service decisions and… more
- Fallon Health (Leominster, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Position Overview:** Our ... participants and their caregivers to provide individualized quality care by a team of geriatric care professionals who work together with participants and caregivers… more
- Bear Mountain Health Care (Lowell, MA)
- …We are currently hiring for an Assessment Coordinator. Formerly known as the MMQ Nurse the Assessment Coordinator works directly with the clinical team to ... the MDS's are generated for admission, quarterly, annually, for Medicare 5 day, and for significant change MDS's ....they have to be done. . Daily monitoring of compliance with the current/ upcoming UDA's by the Assessment… more
- Fallon Health (Dartmouth, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:** ... care throughout the clinic. + Collaborates with participants, caregivers, physicians, nurse practitioners and other staff to meet participants' needs. + Delegates… more
- AccentCare, Inc. (Methuen, MA)
- …your organizational skills and knowledge of at-home care and join the AccentCare team today in this Clinical Support Specialist job. When you join AccentCare, you ... become part of a team that is not only dedicated to their patients,...functions: Stand up/stand down & case conference that ensure compliance KPIs (LUPAS, Paraprofessional Utilization, etc.). Perform other clinical… more
- Sodus Rehab & Nursing Center (Everett, MA)
- …Ensures compliance with federal and state regulations, MA Medicaid, Medicare and Managed Care payment systems. Monitors, consults, and makes effective ... to MDS and MA Medicaid payment methodology. + Extensive knowledge of Medicare reimbursement, compliance , and eligibility. Knowledge, Skills, and Abilities +… more
- Fresenius Medical Center (Danvers, MA)
- …by Newsweek + No late shifts (5:00 am to 6:00 pm Mon-Sat) + Scheduled Team Appreciation Events + NO Overnight, Sunday or on-call shifts. + Major holidays off! ... weeks of paid & structured training with an assigned Preceptor & Nurse Educator** + **Upbeat work environment** + 70,000+ dedicated employees, 200,000+ patients,… more
- Nantucket Cottage Hospital (Nantucket, MA)
- …other weekend** *Job Summary:* The Lead LPN works in collaboration with the Nurse Director, to facilitate safe and effective patient care. This position participates ... clinic operations, flow, and organization in conjunction with the Nurse Director and assigned charge nurse . *...Duties:_* Collaborates with all members of the health care team to ensure coordination of care as indicated. *… more
- Nantucket Cottage Hospital (Nantucket, MA)
- …of patient and family centered health care in an ambulatory care setting. The nurse reports to the Clinical Nurse Manager and is responsible for working ... side by side with the providers, hospital leadership, and health care team to oversee the delivery of quality patient care through the daily operations of the… more
- Fresenius Medical Center (Chelmsford, MA)
- …weeks of paid & structured training with an assigned Preceptor & Nurse Educator** + 70,000+ dedicated employees, 200,000+ patients, 2,600+ dialysis centers, 350+ ... **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for...for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training… more
- Fresenius Medical Center (Weymouth, MA)
- **PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct ... supervision of a licensed nurse in accordance with organization policies, procedures, and training...accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state,… more