- Beth Israel Lahey Health (Burlington, MA)
- …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical… more
- Beth Israel Lahey Health (Burlington, MA)
- …Rotation **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical… more
- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- 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 (Boston, MA)
- …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
- Tufts Medicine (Burlington, MA)
- …and smooth flow of communication and administrative support activities for the Utilization and Case Management departments. This position is well versed in insurance ... state board where services will be provided as a registered professional nurse **OR** Current multi-state licensure through the enhanced Nurse Licensure… more
- Beth Israel Lahey Health (Cambridge, MA)
- …difference in people's lives.** Join our team as a key Emergency Department nurse in our renovated and expanded department, caring for approximately 34,000 patients ... spectrum of life, from pediatrics to older adults. **Job Description:** Registered Nurse - Sign on Bonus eligibility up to $12,000 **Primary Responsibilities** 1.… more
- Veterans Affairs, Veterans Health Administration (Bedford, MA)
- …after complete review of the EDRP application. Responsibilities The Registered Nurse position is located in Nursing, Mental Health at the Bedford campus. This ... at 40 hours per week. VA offers a comprehensive total rewards package: VA Nurse Total Rewards The Inpatient Mental Health (MH) Registered Nurse (RN) provides… more
- Cambridge Health Alliance (Cambridge, MA)
- …team leader in multi-disciplinary team discussion regarding treatment planning, treatment review , quality assurance and utilization review ... Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry...authorizing practice in an expanded role as a Psychiatric Nurse Clinical Specialist and authorization including prescriptive authority. _In… 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
- 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 (Boston, MA)
- …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
- 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 ... in policy review and revision. Works with Home Care Director/Residential Nurse Manager to update policies, procedures and workflows as needed to ensure… more
- Highmark Health (Boston, MA)
- …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
- Erickson Living (Peabody, MA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... indicators/benchmarking such as Falls, Pressure Ulcers, Medication Errors, Restraint Utilization , Re-hospitalization, Anti-psychotic utilization , ADL splits/documentation, etc.… 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
- Dana-Farber Cancer Institute (Newton, MA)
- …specialty pharmacy, oncology, healthcare, or health insurance environment is required. Utilization Review or Prior Authorization experience is preferred. ... escalates any active clinical issue to either a telephonic nurse or pharmacist. + Establishes and maintains strong customer...pharmacy support manager and other pharmacy care coordinators to review cases and related drug therapy and pharmacy care… 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
- 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