- Commonwealth Care Alliance (Boston, MA)
- …Mgmt **Position Summary:** Reporting to the Manager Utilization Management, 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 ensuring CCA meets… more
- Commonwealth Care Alliance (Boston, MA)
- …and quality of all assessments and ensuring timely submission to MassHealth. The department includes registered nurse assessors and reviewers. The assessors ... designed to improve outcomes for CCA members. The Assessment nurse reports to the Regional RN Supervisor.... (must have):** + Associate degree in Nursing + RN with an active registered nursing license… more
- HealthCare Support (Boston, MA)
- RN Assessments (MDS) HealthCare Support is actively seeking an RN Assessments (MDS) to fill an opening with a prestigious Healthcare Organization in Boston, MA . ... Daily Responsibilities for RN Assessments (MDS): Principal Duties and Responsibilities: Conducts in-person...adherence concerns, vital signs, and acute and chronic disease education . Complete additional tools or screeners as needed, including… more
- Commonwealth Care Alliance (Boston, MA)
- …**Required Experience:** Meaningful clinical experience including: + 3+ years' experience as Registered Nurse in a high touch clinical environment or home ... chronic disease management, care coordination, and triage within the RN scope of practice. The Primary Care Triage Nurses...Nurse makes outbound calls in order to do ED , hospital, facility discharge checks, follow up after an… more
- Commonwealth Care Alliance (Boston, MA)
- …and substance use disorder resources. CHWs play an integral role in reducing high emergency department ( ED ) and inpatient utilization related to unmet social ... **Position Summary:** Commonwealth Care Alliance's Community Health Services (CHS) Department is responsible for addressing health related social needs (HRSN)… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Commonwealth Care Alliance's (CCA) Clinical Care Manager is a registered nurse or other independently licensed behavioral health clinician ... CCA members or patients as part of the job duties. **Required Education (must have):** + RN Clinical Care Managers must have: + Associate degree in nursing +… 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 - ... a great fit for this role. Supervision Exercised: - Assumes responsibility for all nursing ( RN , LPN) and MA roles in the practice. 10 - 15 direct reports across… more
- Commonwealth Care Alliance (Boston, MA)
- …millions of people do not have access to proper care and visit Emergency Departments because they have no alternatives. The poor patient experience, the sub-optimal ... care, and the estimated $8.3B spent on unnecessary ED visits each year, make it extremely clear that...We strive to eliminate unnecessary and avoidable visits to Emergency Departments and the inpatient hospital admissions that often… more
- Commonwealth Care Alliance (Boston, MA)
- …up + Assesses the health needs of patients under the supervision of the primary registered nurse . + Establishes plan of care jointly with medical doctor, primary ... forms requested by clinicians. Faxes information to appropriated sources. + Collaborates with Registered Nurse on all cases to ensure delivery of quality patient… more
- Commonwealth Care Alliance (Boston, MA)
- …in ADA administration **Required Licensing:** + Unencumbered license to practice as a Registered Nurse in Massachusetts **Required Experience:** + 5+ years of ... and conduct TB testing where indicated. + Deliver health education and training programs on various health and safety...degree in Nursing + Certification as an Occupational Health Nurse (COHN) or Occupational Health Nurse Specialist… more
- Commonwealth Care Alliance (Boston, MA)
- …plan QI Committee. Co-chair of health plan Utilization Management Committee Required Education : - Bachelor's Degree or equivalent experience Desired Education : - ... degree in Business or Health related field preferred Required Licensing: - active RN license required Required Experience: - 7-10 years - 8-10 years of managed… more
- Commonwealth Care Alliance (Boston, MA)
- …to support organizational initiatives and efforts - Provide training and guidance on department processes and procedures to new team members - Create and implement ... job duties as requested Working Conditions: - Standard office conditions. Required Education (must have): - Bachelor's degree or equivalent in Marketing, Public… more
- Commonwealth Care Alliance (Boston, MA)
- …goals and milestones are achieved + Conduct training and provide guidance on department processes and procedures for new team members + Support the development and ... duties as requested **Working Conditions:** + Standard office conditions. **Required Education (must have):** + Bachelor's degree in Marketing, Public Relations,… more
- Commonwealth Care Alliance (Boston, MA)
- …and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and ... Duties & Responsibilities: The Manager, Utilization Management reports to the Director of Utilization Management - Oversees clinical decision review for services… more
- Commonwealth Care Alliance (Boston, MA)
- 011520 CCA-Customer Service The Member Services Department provides a single point of contact for questions, problem solving, and access to care, for members and all ... hours each day in a distraction free environment. Required Education : - Associate's degree or equivalent experience. Desired ...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Commonwealth Care Alliance (Boston, MA)
- …10 pounds and occasionally lift and/or move more than 100 pounds Required Education (must have): - High School diploma or relevant experience Required Licensing ... None Desired Licensing (nice to have): - Medical Assistant or Licensed Practical Nurse - Coding Certification Required Experience (must have): - 3-5 years of… more
- Terumo Medical Corporation (Boston, MA)
- …Req ID: 5130 Location: Boston, MA, US Company: Terumo Medical Corporation Department : TIS Sales - New England Terumo Medical Corporation (TMC) develops, ... places a premium on providing customers with world-class products, training and education programs that drive clear economic value, better clinical outcomes and… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Valid Driver's License required - up to 20% travel expectation **Required Education (must have):** + Master's Degree in Nursing, or a degree in Physician ... Assistant Studies **Desired Education (nice to have):** + Master's in Public Health...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Commonwealth Care Alliance (Boston, MA)
- …office conditions. - Work locations can include residential and community sites. Required Education (must have): - BA/BS in a related field with strong emphasis in ... acceptable professional references, a background check (including Mass CORI, employment, education , criminal check, and driving record, (if applicable)), an OIG… more
- Commonwealth Care Alliance (Boston, MA)
- …considered at this time._** **Position Summary** The Clinical Operations Support Department (CS) is responsible for providing analytical and operational support to ... compliance. The Senior Business Analyst, Clinical Operations reports to the Director , Clinical Operations Support. This role will provide significant BA support… more
