- Aveanna Healthcare (Worcester, MA)
- …based on client needs, staff expertise, and geographical locations. Ensures office filing/ medical record functions are current, accurate, and effective. ... and direction of in-service educational programs. Maintains ongoing communication with office staff and participates in staff conferences. Assists with performance… more
- Commonwealth Care Alliance (Boston, MA)
- …responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer ... guidelines) and employs clinical expertise to interpret clinical criteria to determine medical necessity of services + Communicates results of reviews verbally, in… more
- Commonwealth Care Alliance (Boston, MA)
- …all assessments and ensuring timely submission to MassHealth. The department includes registered nurse assessors and reviewers. The assessors are organized into ... designed to improve outcomes for CCA members. The Assessment nurse reports to the Regional RN Supervisor....Education (must have):** + Associate degree in Nursing + RN with an active registered nursing license… more
- Commonwealth Care Alliance (Boston, MA)
- …Administrator (RHIA Required Experience (must have): - 2 years experience in a medical office or equivalent combination of education and experience. Required ... of information. - Responsible for recording accurately and consistently in CCAs electronic medical record. - Support clinical teams by obtaining medical record… 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 ... to a panel of health plan members with complex medical , behavioral, and social care needs, including Severe and...Routine member engagement + Quality gap closures, including: + RN Clinical Care Manager + BH Clinical Care Manager… 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 - ... role. Supervision Exercised: - Assumes responsibility for all nursing ( RN , LPN) and MA roles in the practice. 10...accurate documentation. - Oversite for coordination and scheduling of medical appointments - Oversite of education to patients and… 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 ... 025010 Clin Alli-CCAPC **Position Summary:** The Primary Care Triage Nurse functions as a key part of the primary...chronic disease management, care coordination, and triage within the RN scope of practice. The Primary Care Triage Nurses… more
- Jobleads-US (Boston, MA)
- …operations research techniques to model and optimize staffing needs by skill type (eg, RN , PT, HHA), pay type (eg, hourly, salaried), and time type (eg, full-time, ... curious Facilities, Travel and Work Environment To ensure Home or Hybrid Home/ Office employees' ability to work effectively, the self-provided internet service must… more
- Commonwealth Care Alliance (Boston, MA)
- …to conduct intakes and process requests for referrals - Review, validate and process medical records requests from patients in a timely manner - Ensure instED visit ... follow-up care with external care teams, as directed by the Virtual Medical Control providers - Transfer/escalate issues to licensed independent practitioners as… more
- Commonwealth Care Alliance (Boston, MA)
- …Required Licensing (must have): - None Desired Licensing (nice to have): - Medical Assistant or Licensed Practical Nurse - Coding Certification Required ... This patients we serve are most often are individuals with significant medical , behavioral, and social complexities that require intensive care delivery.? Within the… more
- Commonwealth Care Alliance (Boston, MA)
- …Management (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care ... and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and… more
- Commonwealth Care Alliance (Boston, MA)
- …management functions - Using evidence supports BH / Clinical Vice Presidents/ Medical Directors in identifying opportunities to develop, implement and evaluate ... Behavioral Health Care Delivery, in close collaboration with Clinical Vice Presidents/ Medical Directors and the Vice President, Regulatory Affairs and Compliance -… more
- Commonwealth Care Alliance (Boston, MA)
- …engagement, delegation partnerships, provider services, contracting, quality, compliance, medical management, and analytics teams to advance provider network ... Provider Network in collaborative forums and committees, including payment policy and medical policy. Other Duties - Develop and maintain SOPs related to provider… more
- Commonwealth Care Alliance (Boston, MA)
- …health-oriented field is preferred. Technical accreditation in the health care field (ie, Medical Assistant | Billing and Coding) is a plus. Required Experience: - ... working in the health care industry front lines or medical setting preferred - Prior experience with service authorizations,...and punctuality are a must - Proficient with Microsoft Office Suite and demonstrated ability to work with multiple… more
- Commonwealth Care Alliance (Boston, MA)
- …and translate findings into actionable strategies. + Proficiency in Microsoft Office Suite (especially Excel and PowerPoint); comfort with data dashboards, reporting ... and utilization management systems and workflows for populations with complex medical , behavioral health, and/or social needs. + Strong understanding of **Medicare,… more
- Commonwealth Care Alliance (Boston, MA)
- …and utilization, closing care quality gaps, and optimizing member connection to medical , behavioral health, and substance use disorder resources. CHWs play an ... or outreach settings working with clients who have complex needs, including medical , social, behavioral health, or substance use **Desired Experience (nice to… more
- Beth Israel Lahey Health (Wilmington, MA)
- …clinical, technical and clerical duties to ensure quality patient care is provided. The Medical Office RN works in collaboration with the physician(s), other ... plan and coordinate the delivery of patient care. The Medical Office RN demonstrates the...as a responsive team member. 18. Demonstrates role of nurse as teacher. 19. Demonstrates ability to fulfill role… more
- Beth Israel Lahey Health (Woburn, MA)
- …lives.** JOB SUMMARY: BILH Primary Care is where you can truly make a difference. As the Medical Office RN you will work in concert with our providers and ... clinical support staff to ensure that patient needs are met. The Medical Office RN assists patients in navigating their care within our award winning… more
- BAYADA Home Health Care (Wilmington, MA)
- **BAYADA Home Health** has an immediate opening for a **Weekend** ** RN , Registered Nurse ** to perform **home health** **visits** for our **North Boston ... Senior Living** team **.** This office delivers exceptional care to **adult and geriatric patients**...available to complete a full orientation during the week. ** RN , Registered Nurse , Home Health… more
- BAYADA Home Health Care (Bedford, MA)
- …compassionate and dedicated **Weekend Registered Nurse ** to perform home health ** RN visits** for our North Boston Visits office . + **Full Time Benefit ... the opportunity to remain at home and receive the medical care required. ** Registered Nurse ( RN ) Benefits:** + Enjoy being part of a team that cares and… more
