- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… 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 - ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide… more
- Beth Israel Lahey Health (Plymouth, MA)
- …the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… more
- Fresenius Medical Center (Fairhaven, MA)
- …supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... of maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line.… more
- Commonwealth Care Alliance (Boston, MA)
- …that require intensive care management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an interdisciplinary ... and based on the fluctuating needs of the defined panel of members, the Registered Nurse will engage in regular assessments, visits at regularly scheduled… more
- Prime Healthcare (Woonsocket, RI)
- …work experience post-graduation from an accredited school of nursing and a current state Registered Nurse (RN) license. + Minimum of five years acute care ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/233521/ registered - nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)… more
- Fresenius Medical Center (Providence, RI)
- …care pre, during and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques ... and physical structure of the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment in the vascular access… more
- Sharecare (Providence, RI)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- CenterWell (Providence, RI)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's degree in… more
- Beth Israel Lahey Health (Plymouth, MA)
- …job that may reasonably be required._ **Education/Experience Required:** _Required_ + State of MA Registered Nurse (RN) + 3-5 years acute care nursing + Two ... summer and one winter holiday. **Job Description:** The Emergency Department Case Manager is responsible and accountable for patient trajectory by assisting the… more
- State of Massachusetts (Boston, MA)
- …have 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) ... Shattuck Hospital is seeking a dedicated and experienced Case Manager to coordinate key functions within our Case Management...of nursing must have applied for the first available registered nurse examination. Based on assignment, possession… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... or designee. Provides coordinated care support to Physician leadership and Clinical Manager (s) of respective services. Makes daily rounds and collaborates with the… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... or designee. Provides coordinated care support to Physician leadership and Clinical Manager (s) of respective services. Makes daily rounds and collaborates with the… 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 * ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...management team, shared accountability for reductions in acute care utilization * Attend team meetings and huddles to provide… more
- Brockton Hospital (Brockton, MA)
- …preferred. Must have current license from Commonwealth of Massachusetts to practice as a Registered Nurse . Minimum of five years clinical experience in an acute ... guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as the primary liaison...care facility required. Prior experience in case management, utilization review or discharge planning… more
- Deloitte (Boston, MA)
- …clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN, Quality, ... degree in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist… more
- University Medicine (East Providence, RI)
- …endoscopy population of Brown Medicine under the direct supervision of a registered nurse (RN). PRINCIPAL DUTIES AND RESPONSIBILITIES: Consistently applies the ... and body fluids + May have exposure to hazardous equipment/gases/chemical agents Reports to: Nurse Manager & Practice Manager Employees are required to be… more
- Beth Israel Lahey Health (Boston, MA)
- …are not fit for duty. Participates in the evaluation of staff as requested by the nurse manager . + Rounds on the clinical units to assess and address patient ... Nursing Program required. Baccalaureate degree in Nursing strongly preferred. + License Registered Nurse required. + American Heart Association - Basic Life… more
