- Commonwealth Care Alliance (Boston, MA)
- …supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager , and ... a seamless provider experience and consistent delivery of quality care . The BH Provider Engagement Program Manager ...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- Commonwealth Care Alliance (Boston, MA)
- …Long-Term Services Coordinators (LTSC) agencies, ensuring alignment with CCA's model of care and strategic objectives. The Manager fosters effective clinical and ... are met in a manner that supports quality, independence, and cost-effective community-based care . The Manager also ensures providers are educated on CCA… more
- Commonwealth Care Alliance (Boston, MA)
- …and driving record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity ... 011230 CA-Provider Engagement & Performance Position Summary: Commonwealth Care Alliance's Long-Term Services and Supports (LTSS) team is responsible for… more
- Molina Healthcare (Waltham, MA)
- …government funded health plans for members who reside in Massachusetts. We are looking for Care Managers with a RN licensure and a back ground in care ... health settings. + Required License, Certification, Association + Active, unrestricted State Registered Nursing license ( RN ) in good standing + If field… more
- Sharecare (Boston, MA)
- … more accessible and affordable for everyone. To learn more, visit www.Sharecare.com. The Care Manager supports the implementation of the Value Based Care ... telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary… more
- Highmark Health (Boston, MA)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN state licensure… more
- Commonwealth Care Alliance (Boston, MA)
- …Management **Position Summary:** Commonwealth Care Alliance's (CCA) Clinical Care Manager is a registered nurse or other independently licensed ... living, recovery, and community connections. This position allows for remote work, when possible, but does require in-person visits...Routine member engagement + Quality gap closures, including: + RN Clinical Care Manager +… more
- AccentCare, Inc. (Norwood, MA)
- …Location: Norwood, MA Position: After Hours Registered Nurse / RN , Hospice Position Type: Full-Time Remote /Virtual Position: No Coverage Area: Greater ... Overview After Hours Registered Nurse / RN , Hospice... transitions as directed. + If serving as a Care Manager , coordinates all aspects of patient … more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... and driving record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity… more
- CVS Health (Boston, MA)
- …. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... position consists of working intensely as a telephonic case manager with patients and their care team...setting. + A Registered Nurse that holds an active, unrestricted… more
- BD (Becton, Dickinson and Company) (Boston, MA)
- …all other documented quality processes and procedures. **Required experience:** + Licensed Registered Nurse + Previous Urology experience + Comfortable educating ... **Job Description Summary** The Clinical Manager (CM) is responsible for working with the... (CM) is responsible for working with the Home Care sales management team to provide clinical support and… more
- Intermountain Health (Boston, MA)
- …measures. **Job Essentials** + Work collaboratively with Select Health's HEDIS Manager , Quality Consultants, and Data Analyst + Responsible for performing accurate ... software on an assigned laptop + Reviewer will perform remote or offsite medical record reviews with charts collected...when and where the member received are and verify care was received. + Reviewer must pass a medical… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …clinical support and direct patient care for a small panel of patients. The Nurse Care Manager (NCM) and the Care Coordinator will collaborate ... equitable and dignified access to the highest quality health care for all individuals and families experiencing homelessness in... Manager is a perfect opportunity for a Registered Nurse seeking to grow administrative and… more
- Molina Healthcare (Boston, MA)
- …and supports (LTSS), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... severity of illness and the site of service. The Care Manager , LTSS provides support for ...We are looking for a candidate with a MA RN licensure and case management experience. Candidates need to… more
- Molina Healthcare (Worcester, MA)
- …behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... We are looking for a candidate with a MA RN licensure. Candidates with case management and home health...consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex… more
- Beth Israel Lahey Health (Burlington, MA)
- …New England States for consideration** The Clinical Documentation Improvement (CDI) Specialist Registered Nurse ( RN ) assists with the appropriate ... that are representative of the patient's hospital stay and care provided including Severity of Illness (SOI), Risk of...the body of the medical record. The CDI Specialist RN works under the direction of the Manager… more
- Highmark Health (Boston, MA)
- …in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to ... coordinate care , and identifying various resources to assist members in...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
- Bear Mountain Health Care (Boston, MA)
- Bear Mountain Healthcare has immediate openings for a Registered Nurse unit manager looking to work in our Long Term Care Facility in the West Roxbury, ... patient-centered care , promoting healing, recovery, and comfort. The unit manager will oversee only one unit, responsible for 40 residents, ensuring personalized… more
- US Tech Solutions (Canton, MA)
- …and collaboration with member/caregiver and providers, develop a member-specific plan of care , implement member-specific care manager interventions, and ... **Location: Remote ** **Duration: 6 Months Contract (With Possible Extension)**...key providers and vendors actively involved in the member's care . + Collaborate with member/caregiver and the facility … more
- Children's Hospital Boston (Boston, MA)
- …Job Posting Category:NursingJob Posting Description:Department Summary: The Professional Development Practitioner - RN is a registered nurse with nursing ... and presentation skills. Licensure/ Certifications: + Current Massachusetts license as a Registered Nurse ( RN ) + Certification in clinical… more
