- Evolent (Boston, MA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Fenway Health (Boston, MA)
- …patient-centeredness, non-judgmental, harm reduction, behavioral health integration, and team-based care. The nurse serves in a clinical leadership role to the ... Registered Nurse Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type...care team with primary responsibilities for disease management , care coordination, and advice/triage needs for the care… more
- CVS Health (Boston, MA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- Dana-Farber Cancer Institute (Foxborough, MA)
- …Director of Nursing is responsible for the planning, implementation and evaluation of clinical operations and personnel management of the assigned patient care ... the highest quality patient experience while maximizing provider time and space utilization . The Nurse Director uses extensive theoretical, evidence-based, and… more
- Brockton Hospital (Brockton, MA)
- …patient care in a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization : considers factors related to ... Registered Nurse (RN), Part- Time Flex Nights, A2-Telemetry Signature...encompassing nursing, hospitalists, social work, physical therapy, and case management , we strategize patient discharge plans. The unit handles… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Key Qualifications + Strong clinical skills and understanding of HMM's Utilization Management , Case Management and operational procedures, Medical and ... attention. + Partner with Utilization and Care Management to provide clinical support and analysis...levels of the organization. Education and Experience: + Registered nurse with BSN and 3-5 years in a managed… more
- Atrius Health (Newton, MA)
- …includes a minimum of 3 years in utilization management or case management . . Minimum of 3-5 years clinical experience with home health care experience ... health and welfare benefit package. **Job:** **Nursing* **Organization:** **Case Management * **Title:** *CMRN-Ambulatory Nurse Case Manager (MNA)* **Location:**… more
- Beth Israel Lahey Health (Boston, MA)
- …focusing on the delivery of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a safe and ... quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions… more
- Evolent (Boston, MA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... accomplishments. **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Brockton Hospital (Brockton, MA)
- …patient care in a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization : considers factors related to ... Registered Nurse (RN), Part-Time, Flex, Nights, 8 Hour Shift,...than ever. Telemetry Support staff include unit secretaries and clinical care assistants. A2 admits patients primarily from the… more
- Atrius Health (Dedham, MA)
- …of the Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient ... across the lifespan. This position is responsible for effective care delivery and management of patient care within a specialty, utilizing the nursing process and… more
- Beth Israel Lahey Health (Cambridge, MA)
- …with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient ... Case Manager Guidelines and audit tool. Reports to Inpatient Case Management Supervisor. **Job Description:** **Essential Duties & Responsibilities (including but… more
- Fresenius Medical Center (Medford, MA)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... by working with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are followed. + Responsible… more
- Brockton Hospital (Brockton, MA)
- …responsibilities include the development and supervision of staff (RNs, LPN's,SWs and non- clinical support), evaluation and maintenance of case management skills ... include the development and supervision of staff (RNs, LPN's, SWs and non- clinical support), evaluation and maintenance of case management skills and… more
- Deloitte (Boston, MA)
- … registered nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG ... and informal education of physicians, CDI team, health information management and other clinical staff + Develop...medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical … more
- Edwards Lifesciences (Boston, MA)
- …post-case management , 3 Mensio management , Therapy Awareness program management and clinical education programs. + Implementing sales and educational ... and implementing growth strategies within focused accounts in partnership with Sales Management . + Developing clinical champions among current and potential… more
- Beth Israel Lahey Health (Boston, MA)
- …and Emergency Department. In absence of Admission Facilitator, directs bed utilization . + Provides clinical consultation, support, education and mentoring ... in the evaluation of staff as requested by the nurse manager. + Rounds on the clinical ...and across functional areas. Results have implications for the management and operations of multiple areas of the organization.… more
- Philips (Cambridge, MA)
- …etc) with clinical experience as Radiologic Technologist (RT) or Registered Nurse (RN) highly preferred. + Experience in healthcare (in the hospital) within ... **Sales Support, Clinical Specialist - FORS (West/National Travel)** In this...to effectively manage assigned accounts in terms of driving utilization , customer relationship management , problem resolution, etc.… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …multiple units of care and within the Nursing Department. + Collaborates with Clinical Nurse Directors, Managers, Clinical Specialists, and interprofessional ... utilization of professional standards at the unit and department level. + Guides nurse leaders and clinical nurses in quality improvement and the translation… more
- Cambridge Health Alliance (Somerville, MA)
- …**Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job Type:** Per ... Experience strongly preferred. + Provider Minimum of 5 years of broad clinical experience, predominately in medical/surgical nursing. Case Management experience… more