- Children's Hospital Boston (Boston, MA)
- …Hours per Week:40 Job Posting Category:NursingJob Posting Description:The Utilization Review Nurse will be ... with established procedures, guidelines and criteria + Focusing on high priority utilization review activity including: conducting emergency admission level of… more
- Humana (Providence, RI)
- …our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to support ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines and… more
- Brockton Hospital (Brockton, MA)
- …delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare ... management experience Proven experience in coordinating discharge planning and utilization review experience required. Prior management experience required.… more
- Evolent (Providence, RI)
- …be the single point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work can be divided into ... for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for utilization … more
- Highmark Health (Providence, RI)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- Tufts Medicine (Boston, MA)
- …**Job Overview** This position is responsible for the direction of Nurse Practitioners, including arrangement of schedules, staffing during vacations, direction of ... **Minimum Qualifications** **:** 1. Master's degree in Nursing (MSN). 2. Registered Nurse (RN) license. 3. Advanced Practice Registered Nurse (APRN) license.… more
- GE Vernova (Foxborough, MA)
- …+ Hold operating rhythm, pacing calls on Resource/workload management, Engineering utilization , Budget Deviation, On Time Delivery (OTD), Say Do Ratio (SDR), ... Customer comments. + Collaborate with Project Controls to have monthly rhythm to review workload vs capacity and work with department managers on their respective… more
- Brown University (Providence, RI)
- …helps patients reduce medications that cause falls. Both models are led by a remote nurse who will review electronic health records and consult with an external ... team of experts to devise a personalized medication treatment plan. The nurse will provide information about osteoporosis treatment and/or reducing medications to… more
- State of Massachusetts (Wrentham, MA)
- …for but not limited to, maintaining safe nursing staffing patterns, utilization and deployment of staffing resources, management of budgets, overtime costs ... the performance of unit assigned supervisory nursing staff by direct observation, review reports, supervision meetings, and collaboration with Unit Mangers to ensure… more
- Brockton Hospital (Brockton, MA)
- …of five years clinical experience in an acute care facility required. Prior experience in case management, utilization review or discharge planning required. ... the delivery of services. Uses accepted criteria and guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as… more
- Brockton Hospital (Brockton, MA)
- …of five years clinical experience in an acute care facility required. Prior experience in case management, utilization review or discharge planning required. ... the delivery of services. Uses accepted criteria and guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as… more
- Evolent (Providence, RI)
- …years of direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + Cardiology and Oncology ... + Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of three… more
- Tufts Medicine (Boston, 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
- Intermountain Health (Boston, MA)
- …anatomy and physiology. medical training such as medical assistant, certified nurse assistant, emergency medical technician. **Job Description Summary** Assesses and ... patients and/or patient's family, caregivers, and/or legal representatives socio-economic review and screening to support coordination of care. Plans interventions… more
- Tufts Medicine (Boston, 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