- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Nurse Utilization Management (UM) Reviewer is responsible for ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...+ CCM (Certified Case Manager) preferred + 1 to 2 years Utilization Management experience… more
- Humana (Boston, MA)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
- Veterans Affairs, Veterans Health Administration (Bedford, MA)
- …AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and 1 year of professional nursing experience ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic...equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Beth Israel Lahey Health (Cambridge, MA)
- …significant data to appropriate personnel throughout the patient's emergency department experience. 2 . The emergency nurse analyzes assessment data to formulate ... a job, you're making a difference in people's lives.** Registered Nurse - Emergency Department **Job Description:** **Primary Responsibilities** 1. The emergency… more
- Fenway Health (Boston, MA)
- Registered Nurse Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+02215) * Nursing Job Type Full-time Description As a Registered Nurse (RN) ... care to individuals, families, communities, and patient populations. The Registered Nurse 's care delivery is consistent with the Massachusetts Board of Registration… more
- Atrius Health (Burlington, MA)
- …in the country. ** *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support ... 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
- Cambridge Health Alliance (Cambridge, MA)
- Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry Apply (https://careers.chaproviders.org/clinical-specialist- 2 -psychiatry) Refer a Friend Back ... discussion regarding treatment planning, treatment review, quality assurance and utilization review function/procedures. + Administers medication according to nursing… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. Two years of case management or utilization management experience desirable. * Demonstrated ... utilization review and discharge planning to inpatient admissions. 2 ) Applies Interqual, AEP and or other review criteria...needed. 10) Supports all service line activities related to utilization and quality management . 11) Assists in… more
- Humana (Boston, MA)
- …ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, Durable ... caring community and help us put health first** The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance Professional 2 … more
- Cambridge Health Alliance (Everett, MA)
- …Hospital **Work Days:** 8:00-4:30pm Rotating Wkends and Holidays **Category:** Registered Nurse **Department:** Inpatient Case Management Everett **Job Type:** ... RN Case Manager - Inpatient Case Management Everett Apply Refer a Friend Back **Date...part time employees) for newly hired experienced RNs with 2 years of experience in the specialty hired for.**… more
- Tufts Medicine (Boston, MA)
- …in the service of the federal government **OR** Massachusetts's Licensed Practical Nurse (LPN). 2 . Graduate of an accredited Surgical Technologist program ... incision of a patient's body, such as interventional pain management and other procedures. This position also works to...3. Basic Life Support (BLS) certification. 2 . Surgical Technologist certification (CST). 3. Basic Life Support… more
- Tufts Medicine (Boston, MA)
- …functions in the service of the federal government **OR** Massachusetts's Licensed Practical Nurse (LPN). 2 . Basic Life Support (BLS) certification. 3. Surgical ... incision of a patient's body, such as interventional pain management and other procedures. This position also works to...Certified within one (1) year of hire 4. Two ( 2 ) years of experience as a Surgical Technologist, scrubbing… more
- Tufts Medicine (Malden, MA)
- …level preferred-Registered Nurse BSN preferred, or Physical Therapist with two ( 2 ) years' experience in community health/home health 2 . Prior Supervisory ... with agency policy, State and federal home health regulations. Responsible for the management of cost effective, efficient care to home health patients ensuring the… more
- Tufts Medicine (Burlington, MA)
- …Advisors/Champions. **Job Description** **Minimum Qualifications:** 1. Bachelor's Degree in Nursing 2 . Active Registered Nurse (RN) license in Massachusetts or ... setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership… more
- Tufts Medicine (Tewksbury, MA)
- …etc.) **Job Description** **Minimum Qualifications:** 1. Bachelor's degree in Nursing (BSN). 2 . Registered Nurse (RN) license. 3. Basic Life Support (BLS) ... expectations, continuing education, credentialing, performance appraisals, auditing, concurrent monitoring, utilization review, risk management and active problem… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …range planning and determining staffing needs. + Assists Home Care Manager/Residential Nurse manager to monitor utilization and processes for stocking Nursing ... Interdisciplinary Teams (IDT), providing assistance with oversight of health aide and nurse scheduling, and providing direct supervision of health aides. Works on… more
- Elevance Health (Woburn, MA)
- …Level:** Non- Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation ... responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment… more
- Beth Israel Lahey Health (Cambridge, MA)
- …1. Receives requests from surgeons and/or secretaries for Operating Room time. 2 . Reserves specialty equipment as requested for procedures, checking for availability ... of procedures, including case setup and turnaround time. 4. Consults with the nurse manager and anesthesiologist to determine the priority of on-call or urgent cases… more
- Beth Israel Lahey Health (Cambridge, MA)
- …2 . Three years of medical/surgical nursing care experience. Two years of case management or utilization management experience. 3. Basic computer and ... a job, you're making a difference in people's lives.** Case Management : Case Manager **Job Description:** **Primary Responsibilities** 1. Performs discharge planning… more
- Beth Israel Lahey Health (Milton, MA)
- …or managed care setting + 2 years prior experience in Case Management , preferred (Discharge Planning and Utilization Review + Current knowledge of federal, ... just taking a job, you're making a difference in people's lives.** The Case Management Department provides case management services to patients in the Emergency… more