- Evolent (Boston, MA)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible… more
- Cognizant (Boston, MA)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. . Medical Necessity Reviews can… more
- Dana-Farber Cancer Institute (Boston, MA)
- …for a non-oncology area, eg infection control) and the process of conducting medical clinical research. In addition, the CRN utilizes evidence-based nursing ... The Research Nurse in collaboration with the physician, is responsible...physician, is responsible for the implementation and evaluation of clinical research in their specific program/area. The CRN has… more
- BAYADA Home Health Care (Wilmington, MA)
- …DCO to ensure cohesive and consistent management of all field staff. + Review all clinical documentation to ensure consistent, accurate, high-quality services. + ... BAYADA Home Health Care is seeking a Registered Nurse (RN) to fill the position of **Home...holidays, vacation and sick leave. + Vision, dental and medical health plans. + Employer paid life insurance, 401k… more
- Beth Israel Lahey Health (Burlington, MA)
- … necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized case ... of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity,...staff on best practices to ensure reimbursement based on medical care provided. 11. Maintains and reports clinical… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Qualifications:** 1. Bachelor's degree preferred. Current state license as a Registered Nurse . 2. Three years of medical /surgical nursing care experience. Two ... (MAH) is a 200-bed acute care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates… more
- Beth Israel Lahey Health (Cambridge, MA)
- …reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret data, and implement ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...state and federal regulators, insurance appeals, internal correspondence, and clinical summaries for medical peer review… more
- Beth Israel Lahey Health (Cambridge, MA)
- …through the entire course of the treatment journey! **Job Description:** Description: The Medical Oncology Nurse Navigator is a professional registered nurse ... to help overcome healthcare system barriers. Utilizing the nursing process, the Medical Oncology Nurse Navigator provides education and resources to facilitate… more
- Beth Israel Lahey Health (Jamaica Plain, MA)
- …care or family medicine practice and serves as a clinical resource for the medical practice. The Team Nurse provides high quality, direct patient care in a ... delegation of clinical and administrative functions as appropriate to the Medical Assistant (MA) staff. Responsible for educating and training our MA team and… more
- Beth Israel Lahey Health (Watertown, MA)
- …care or family medicine practice and serves as a clinical resource for the medical practice. The Team Nurse provides high quality, direct patient care in a ... delegation of clinical and administrative functions as appropriate to the Medical Assistant (MA) staff. Responsible for educating and training our MA team and… more
- Fresenius Medical Center (Roxbury, MA)
- …12 weeks of paid & structured training with an assigned Preceptor & Nurse Educator** + 70,000+ dedicated employees, 200,000+ patients, 2,600+ dialysis centers, 350+ ... of the hemodialysis health care team as a Registered Nurse Applicant under the direction or supervision of a...transcribes and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Commonwealth Care Alliance (Boston, MA)
- … experience in primary care or care management, including: + 5+ years' experience as Registered Nurse in a high touch clinical environment or home care + AND + ... CCA's patients incorporates the care of individuals with significant medical , behavioral, and social complexities that require intensive care...and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an… more
- Veterans Affairs, Veterans Health Administration (Jamaica Plain, MA)
- …the delivery of high-quality patient care while supporting and collaborating with the Nurse Manager and medical /mental health staff. The Assistant Nurse ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Dana-Farber Cancer Institute (Newton, MA)
- The staff nurse 's responsibilities include assessment, planning, implementation and evaluation of nursing care for a complex patient population. The infusion ... nurse provides patient and family education and psychosocial and...own professional goals and learning needs. The role requires clinical expertise, critical thinking, collaborative practice, excellent communication skills… more
- Tufts Medicine (Stoneham, MA)
- …with physician orders. In addition, this role focuses on performing the following Clinical Nurse duties: Assesses, plans, implements, and evaluates the care ... group of patients or provides nursing care and identified clinical support tasks within the scope of practice for...Bachelor's degree in Nursing (BSN). Associates degree considered with review of Nurse Executive Council. 2. Registered… more
- State of Massachusetts (Tewksbury, MA)
- …at least (A) two years of full-time, or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility and (B) of ... candidates to apply for the Day Supervisor - Registered Nurse IV opening currently available. The Day Supervisor -...Dr. Stats and Help Calls on the psychiatric and medical units, IV insertion and assisting in providing care… more
- Beth Israel Lahey Health (Boston, MA)
- …close contact within three feet for at least five minutes). Examples: physicians, clinical nurses, phlebotomist, medical assistants, PFT tech, and x-ray tech.- ... of patients, families, and communities. Reporting directly to the Ambulatory Hematology/Oncology Nurse Manager, the LPN II performs the duties of a Licensed… more
- Fallon Health (Foxborough, MA)
- …Information (CORI) results and reliable transportation **Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members ... the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge,… more
- State of Massachusetts (Tewksbury, MA)
- …at least (A) one year of full-time, or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility, or (B) any ... meetings to facilitate discharge. * Performs duties of medication and treatment nurse following pertinent policies and procedures to carry out physician's orders in… more