- Milford Regional Medical Center (Milford, MA)
- …services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization ... 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria more
- Beth Israel Lahey Health (Burlington, MA)
- …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
- Beth Israel Lahey Health (Burlington, MA)
- …40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... **Why This Role is Important to Us:** The Nurse Utilization Management (UM) Reviewer is...is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Utilization… more
- Elevance Health (Woburn, MA)
- …medical decisions to members 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 ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Commonwealth Care Alliance (Boston, MA)
- …case review , workflow review and other relevant business related to utilization review process. + Works in collaboration with the UM Manager to promote ... management and leadership with the development, refinement and enhancement of utilization management workflows, policies and procedures. + Participate in committees… more
- Beth Israel Lahey Health (Cambridge, MA)
- …America) Job Description Job Description Primary Responsibilities 1. The emergency nurse initiates accurate and ongoing assessment of physical, psychological and ... focused subjective and objective data through history taking, physical examination, review of records and communication with health care providers, significant… more
- Universal Health Services (South Attleboro, MA)
- …team and identifying patient treatment needs, medication assessments and adjustments, and utilization review support as needed. Fuller Hospital is a 109-bed ... Responsibilities Psychiatric Nurse Practitioner Opportunity Fuller Hospital is seeking a...leaders that educate the field, routinely exchange ideas, and review current topics within the industry. Having the opportunity… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Description:** **Primary Responsibilities** (including but not limited to): 1. Performs utilization review and discharge planning to inpatient admissions to ... with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient… more
- Elevance Health (Boston, MA)
- ** Nurse Reviewer I** **Location:** Within 50 miles of a pulse point **Shift** : Monday - Friday, from 9:30 am - 6 pm The ** Nurse Reviewer I** is responsible for ... on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with… more
- Amergis (Burlington, MA)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... Nurse Manager RN -Travel Contract Location: Burlington, MA...of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical… more
- Beth Israel Lahey Health (Needham, MA)
- …clinical leader to bring best clinical practice to the bedside. The nurse manager provides 24-hour operational accountability for their unit(s). Collaborates with ... improvement activities to enhance patient care and improve service. Additionally, the Nurse Manager participates in the development of and implementation of care and… more
- Beth Israel Lahey Health (Boston, MA)
- …and quality management as needed. (essential) 6. Refers cases as appropriate to the Utilization Review Physician for review and determination of need for ... and advocating for the health of patients, families, and communities. The Nurse Case Manager provides utilization management, care coordination and discharge… more
- State of Massachusetts (Marlborough, MA)
- …within Massachusetts nursing homes, hospitals and other health care facilities, and review inspection findings. The Health Care Facility Surveyor will play a vital ... in order to determine the degree of acceptance and utilization of health care, type and breadth of service,...3-5 years of professional work experience as a Registered Nurse working in a health care facility, preferably nursing… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... point-of-care testing, treatments, and lab and diagnostic test result review + Documents patient care, ongoing evaluation, patient progress/risk status,… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... medication reconciliation, point-of-care testing, treatments, and lab and diagnostic test result review + Provides timely and informed patient triage + Involves the… more
- Marriott (Boston, MA)
- …workers' compensation losses. The NCM is responsible for conducting first level Utilization Review and coordinates subsequent levels if necessary, as required ... **Additional Information** Nurse CARE Manager (CARE - Coordinated Action and...that may include multiple states. + Conducts first level utilization review per jurisdictional requirements. + Coordinates… more
- CenterWell (Marlborough, MA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Beth Israel Lahey Health (Burlington, MA)
- …Manager, and in conjunction with the appropriate clinical personnel, (ie department nurse manager or clinical manager), coordinates and manages the procurement of ... the Supply Chain Coordinator will assure supply availability and efficient utilization of supply resources. **Job Description:** Essential Duties & Responsibilities… more
- Brockton Hospital (Brockton, MA)
- …readmissions, improve HCAHPS, drive positive discharge outcomes and reduce LOS, and review ER utilization using proactive approaches to any barriers. The ... the patient's primary care team which includes the MD/NP, social worker, nurse , secretary, medical assistant, and other key stakeholders/staff as needed. The… more