- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- Beth Israel Lahey Health (Burlington, MA)
- …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management team ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
- Tufts Medicine (Boston, MA)
- …years of demonstrated clinical nursing practice including progressive leadership responsibilities. 2. Registered Nurse ( RN ) License. 3. Basic Life Support ... physician orders. In addition, this role focuses on performing the following Clinical Nurse duties: Assesses, plans, implements, and evaluates the care needs of a… more
- Fenway Health (Boston, MA)
- …MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Full-time Description As a Registered Nurse ( RN ) at Fenway Health ... patient, and other care team members. + Influences appropriate utilization of healthcare resources by helping to coordinate patient...+ Education: Associate degree in nursing + Current Massachusetts Registered Nurse ( RN ) license degree… more
- Fresenius Medical Center (Peabody, MA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Massachusetts Institute of Technology (Cambridge, MA)
- Registered Nurse , Care Coordinator + Job Number: 25320 + Functional Area: Health Care + Department: MIT Health + School Area: Executive Vice President + Pay ... Email a Friend Save Save Apply Now Posting Description REGISTERED NURSE , CARE COORDINATOR, MIT Health, will...Graduate of an accredited nursing program; bachelor's degree; current RN license in Massachusetts; CPR Certified; a minimum of… more
- CVS Health (Boston, MA)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Atrius Health (Peabody, MA)
- …and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Peabody - Full ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience. Experience with an electronic medical records system… more
- Atrius Health (Boston, MA)
- …health and welfare benefit package. **Job:** **Nursing* **Organization:** **Nephrology* **Title:** * Registered Nurse (MNA) Nephrology - Kenmore - Per diem* ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience. Experience with an electronic medical records system… more
- Beth Israel Lahey Health (Boston, MA)
- …you're not just taking a job, you're making a difference in people's lives.** The RN Case Manager working in the Triad Model of Care Transitions partners with the ... the hospitalized patient. Together with the medical provider, the RN Case Manager collaborates with all members of the...of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by leading the ... on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of...reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts,… more
- Lawrence General Hospital (Methuen, MA)
- Job Description: The RN Care Coordinator is responsible for overseeing the appropriateness of care provided to members of health plans contracted by the hospital and ... appropriate financial and clinical outcomes of these patients. The RN Care Coordinator will be assigned to selected areas...of the Hospital on a rotating basis to perform utilization reviews and other UM activities, as needed, to… more
- Lawrence General Hospital (Methuen, MA)
- …below the top of the range to support future salary growth. The RN Care Manager collaborates with physicians, nurses, and other clinical staff/directors to ... acute care setting with discharge planning, continuing care, care management, and utilization review preferred. + Strong verbal and written communications skills +… more
- North Shore Community Health (Gloucester, MA)
- …community healthcare delivery. The Primary Care Team Nurse Care Manager (PC team RN CM) is a registered nurse whose primary responsibility is managing ... care teams, and community care providers, the PC team RN CM coordinates the overall health care utilization...Perform nurse visits independently and within the registered nurse scope of practice outlined by… more
- Cambridge Health Alliance (Cambridge, MA)
- …**Work Days** : Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category** : Registered Nurse **Department** : Inpatient Case Management CH **Job Type** ... RN Case Manager - Inpatient Case Management CH...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Cambridge Health Alliance (Everett, MA)
- …**Work Days** : Mon - Friday and Rotating Weekends/Holiday **Category** : Registered Nurse **Department** : Inpatient Case Management Everett **Job Type** ... RN Case Manager - Inpatient Case Management Everett...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Cambridge Health Alliance (Somerville, MA)
- …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job ... RN Case Manager - Inpatient Case Management SH...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Dana-Farber Cancer Institute (Boston, MA)
- …Bachelor's and Master's degrees required, one of which must be in Nursing. + Registered Nurse with 3-5 years' experience in health care, with progressive ... administrative experience **License/Certification/Registration Required** + Licensed as a Registered Nurse in the Commonwealth of Massachusetts and or New… more
- Evolent (Boston, MA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more
- Beth Israel Lahey Health (Cambridge, MA)
- …**Minimum Qualifications:** 1. Bachelor's degree preferred. 2. Current Massachusetts state license as a Registered Nurse ( RN ). 3. Two years of recent acute ... with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient… more
