- Veterans Affairs, Veterans Health Administration (Bedford, MA)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA offers a comprehensive total rewards ... package: VA Nurse Total Rewards This is an open continuous announcement...education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic… more
- Elevance Health (Woburn, MA)
- …and over- utilization by performing medical reviews via prepayment claims review and post-payment auditing. + Correlates review findings with appropriate ... Nurse Auditor Senior - Carelon Payment Integrity **Location:**...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by healthcare providers through prepayment… more
- Fallon Health (Worcester, MA)
- …in the region. **Responsibilities** **R** **esponsibility Summary:** Serves as a float Nurse Practitioner (NP) to each of the Summit ElderCare sites throughout ... documentation of all services provided according to professional + Identifies utilization and service delivery problems and participates in their + Participates… more
- Fallon Health (Lowell, MA)
- …of all services provided according to professional standards + Identifies utilization and service delivery problems and participates in identifying a resolution ... activities including but not limited to record reviews, outcome measurement and review /revision of policies and procedures + Provides education and training to… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... point-of-care testing, treatments, and lab and diagnostic test result review + Provides timely and informed patient triage +...shifts on a rotating basis. Required Qualifications: + Registered Nurse License in MA + Bachelor's degree in Nursing… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... point-of-care testing, treatments, and lab and diagnostic test result review + Documents patient care, ongoing evaluation, patient progress/risk status,… more
- Bear Mountain Health Care (Lowell, MA)
- …+ Meetings: Attending various meetings, including Morning Clinical Meeting, Utilization Review , At-Risk/Behavior Meeting, and QAPI (Quality Assurance ... and Performance Improvement). Qualifications: + Prior experience as an Assessment Coordinator or similar role in a long-term care facility. + Strong knowledge of UDA and MDS assessments. + Proficient in medical documentation and record-keeping. + Excellent… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …Aide's responsibility is to provide clinical and administrative support to the Home Health Utilization Nurse , the Transition of Care Nurse and the agencies ... to track patients and their services. + Escalate concerns to Home Health Utilization Nurse appropriately. + Performs general clerical duties, including document… more
- Covenant Health (Nashua, NH)
- …attended /documented. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices. ... communication. + Supports the role of the clinical primary nurse and utilizes their clinical expertise and input in...medical necessity (whether based on initial or continuing stay review ) to determine whether a level of care change… more
- Elevance Health (Woburn, MA)
- …responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment ... claims review , post payment auditing, and provider record review...goals, policies and procedures. + Investigates potential fraud and over- utilization by performing the most complex medical reviews via… more
- Tufts Medicine (Burlington, MA)
- …(ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management, utilization review , denials management, or progressive leadership in an ... other Quality indicators where indicated. 10. Collaborates with case management and utilization review team to ensure that documentation is clearly substantiated… more
- Tufts Medicine (Chelmsford, MA)
- …providers who are absent, etc.) by making continual adjustments in room utilization and assignment. 2. Prepares medical record for patient visit, confirming accuracy ... arranging for diagnostic testing, surgery and in-patient admissions under direction of the nurse or physician. 14. Assists with patient billing by ensuring CPT code,… more
- Tufts Medicine (Dracut, MA)
- …providers who are absent, etc.) by making continual adjustments in room utilization and assignment. 2. Prepares medical record for patient visit, confirming accuracy ... arranging for diagnostic testing, surgery and in-patient admissions under direction of the nurse or physician. 14. Assists with patient billing by ensuring CPT code,… more