- 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
- Lincoln Financial Group (Boston, MA)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… 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
- Beth Israel Lahey Health (Cambridge, MA)
- …lives.** 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
- Elevance Health (Woburn, MA)
- ** Nurse Audit Lead** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… 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 (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
- 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
- Beth Israel Lahey Health (Wakefield, MA)
- …Working with the healthcare team, the Care Manager, RN monitors appropriate utilization of healthcare resources, promotes quality and efficiency by developing and ... management by focusing care coordination attention on the at-risk population driving utilization and costs to improve efficiency, quality and patient satisfaction. +… 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
- Edward M. Kennedy Community Health Center, Inc. (Milford, 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
- Commonwealth Care Alliance (Boston, MA)
- …member needs are consistently met + Manage panel-wide and member-specific utilization trends. + Liaise with CCA and community-based PCPs/specialists + Collaborate ... planning. + MA / MI only: Reviews approved authorizations to assess appropriate utilization , based on members' needs + Actively participate in the evaluation of own… 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
- 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
- Amergis (South Weymouth, MA)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... up experience + Inpatient hospital experience + EPIC experience + Active Massachusetts Registered Nurse License + COVID Vaccine + Booster + Flu Vaccine + BLS & ACLS… more
- Tufts Medicine (Burlington, MA)
- …(ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management, utilization review , denials management, or progressive leadership in an ... other Quality indicators where indicated. 10. Collaborates with case management and utilization review team to ensure that documentation is clearly substantiated… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …strategies. Your Day to Day: + With minimal oversight, leads CMS utilization management related compliance activities including: + Identify and implement new CMS ... UM letters against medical necessity criteria and accreditation and regulatory criteria + Review applicable policies and procedures to ensure all are up to date and… more