- Commonwealth Care Alliance (Boston, MA)
- …Data Set ( MDS ) Clinical Review team of the Care Planning Unit. The RN MDS Reviewer supports successful completion and submission of the MDS ... for CCA members and ongoing tracking and monitoring. The RN MDS Reviewer is a...Education:** + Bachelor's Degree in Nursing **Required Licensing:** + Registered Nurse with current Massachusetts license in… more
- Athena Health Care Systems (Marlborough, MA)
- We are hiring an MDS Director to join our dynamic care team at Marlborough Hills Rehabilitation & Health Care Center in Marlborough! $4,000 sign-on bonus available* ... and talents are nurtured to allow you to grow within the company. As the MDS Director, you plan, organize, and direct the MDS process involving overseeing… more
- Evolent (Boston, MA)
- …**Qualifications Required and Preferred:** + Current, unrestricted state licensure as a Registered Nurse - **Required** + Associate or Bachelors in Nursing (Must ... **What You'll Be Doing:** Job Description As a Clinical Reviewer , Nurse , you will be a key member...be a Registered Nurse ) - **Required** + You must be… more
- Fallon Health (Leominster, MA)
- …according to policy guidelines including physical, psychosocial, behavioral, and MDS -HC as indicated. + Involves participants and significant other(s) based ... evaluates therapeutic interventions. + Participates in the development and ongoing review of each participant's care plan. + Delegates participants' care… more
- Fallon Health (Worcester, MA)
- …care related field preferred. **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case ... Program Assessment Tools and Minimum Data Set Home Care ( MDS HC) Form when a member's medical/functional status changes...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
- Commonwealth Care Alliance (Boston, MA)
- …reviews with MDs , and preparation of case samples for audit review . This position works collaboratively with the AG Representatives and Management to support ... regulations. **Essential Duties & Responsibilities:** + Conduct monthly case review of a random sample of appeals and grievance...results + Schedule Peer to Peer calls between requesting MDs and CCA MDs , per NCQA requirements.… more