- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- CenterWell (Boston, MA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Beth Israel Lahey Health (Burlington, MA)
- …the medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized ... necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue...in a clear and concise manner to the medical, clinical , and management staff. 12. Applies diplomacy… more
- Evolent (Boston, MA)
- … Reviewer, Nurse , you will routinely interact with leadership and management staff, other CR's ( Clinical Reviewers), providers, office staff and Field ... culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer, Nurse , you will be a..., you will be a key member of the utilization management team. We can offer you… more
- 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
- Fresenius Medical Center (Peabody, MA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Beth Israel Lahey Health (Boston, MA)
- …Demonstrates professional commitment and is responsible for ensuring patient safety. **Resource Utilization ** + The registered nurse considers factors related to ... job, you're making a difference in people's lives.** Operating Room (OR) Registered Nurse - New England Baptist Hospital Full Time Operating room Registered Nurse… 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
- Beth Israel Lahey Health (Cambridge, MA)
- …completed). **KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED** 1. RN with experience in risk management , quality assessment, or utilization management . 2. Strong ... reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review...clinical abstracts, identifies quality of care and risk management issues. Uses clinical knowledge to assess… more
- North Shore Community Health (Gloucester, MA)
- … management . + Pharmacy services. + Substance abuse disorder treatment. + Nurse care management . + Insurance enrollment assistance. NSCH operates service ... Primary Care Team Nurse Care Manager Gloucester, MA (http://maps.google.com/maps?q=302+Washington+Street+Gloucester+MA+USA+01930) Description Primary Purpose of… more
- Dana-Farber Cancer Institute (Attleboro, 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
- Atrius Health (Dedham, MA)
- … Professional* **Organization:** **Orthopedics* **Title:** *Specialty Physician Assistant/ Nurse Practitioner (MNA) - Orthopedics (OR)* **Location:** *Dedham MA ... value-based care system in the country. *_SUMMARY_*__ Physician Assistant/ Nurse Practitioner (MNA) position supporting our Orthopedics department. The Physician… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work ... Office products including Word, Excel and Outlook **Preferred Qualifications** + Utilization Review/Quality Management experience + Experience working with MCG… 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
- Beth Israel Lahey Health (Danvers, MA)
- …to $3000** + **Day 1 Benefits!** + **Schedule: Monday - Friday, days** The Nurse Manager is responsible for the management of the medical/nursing services ... application of Quality Assurance and Customer Service Programs, implementation of Utilization Review mechanisms; structuring clinical supervision; provision of… more
- Atrius Health (Boston, MA)
- …providers to ensure efficient and outstanding quality of care. This registered professional nurse provides practice support to a clinical team, recognizing the ... the direction of the Department Chief Physician and Nursing Supervisor, this Registered Nurse position is responsible for effective care delivery and management … 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
- Atrius Health (Boston, 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
- Atrius Health (Boston, 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
- 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
