- 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
- 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 , ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… 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
- Commonwealth Care Alliance (Boston, MA)
- … Nurse Supervisor and is under the general supervision of the Primary Care Manager and Clinical Director. **Supervision Exercised:** + None **Essential Duties ... team through health maintenance and chronic disease management, care coordination, and triage within the RN ...Meaningful clinical experience including: + 3+ years' experience as Registered Nurse in a high touch clinical… more
- 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)
- …to delegated providers, and supporting the implementation of CCA's model of care and strategic objectives. The Manager leads performance evaluation and ... 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
- Commonwealth Care Alliance (Boston, MA)
- …high-quality, coordinated care in alignment with the health plan's model of care and strategic objectives. The Manager will also oversee corporate and ... 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
- 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 ... 081730 instED-Information Technology **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be… 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
- 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 ... leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines of business. This role… 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 ... for building, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital,… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies, approaches and ... business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess...skills to make an impact** **Required Qualifications** + Active Registered Nurse ( RN ) license with… more
- Molina Healthcare (West Roxbury, 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
- 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
- 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
- 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
- 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
- AccentCare, Inc. (Norwood, MA)
- … Nurse Location: Norwood, MA Position: Patient Care Manager Registered Nurse Position Type: Full-Time Remote /Virtual Position: No Find Your ... Passion and Purpose as a Full-Time Patient Care Manager Registered Nurse Salary: $90,000 - $115,000 #AC-BO Offer Based on Years of Experience What You… more
- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and ... the care and wellbeing of members. The Care Manager , Telephonic Nurse 2...skills to make an impact** **Required Qualifications** + Unrestricted Registered Nurse ( RN ) license in… more
