- Cognizant (Providence, RI)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Fresenius Medical Center (Fairhaven, MA)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- CVS Health (Woonsocket, RI)
- …+ 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
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part- Time Flex Nights, A2-Telemetry Signature Healthcare's Brockton Hospital is hiring for a Part Time Flex Registered Nurse (RN) ... during off-shifts to enhance patient care, staffing, and throughput coordination. Registered Nurse (RN) Roles and Responsibilities: + Assessment: collects… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part-Time Flex Varied 5p-3a, 7p-5a, Emergency Signature Healthcare's Brockton Hospital is hiring for a Part-Time Flex Varied 5p-3a, 7p-5a ... Registered Nurse (RN) for Emergency Room in...Registered Nurse (RN) for Emergency Room in Brockton, MA. Type:...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization :… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Part-Time, Flex, Nights, 8 Hour Shift, Telemetry Signature Healthcare's Brockton Hospital is hiring for a Part-Time, Flex, 8 Hour Shift, ... Registered Nurse (RN) for Telemetry in Brockton,...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization :… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN), Full Time Flex...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization : ... Brockton Hospital is hiring for a Full Time Flex, Evenings & On Call, Registered Nurse (RN) for Operating Room in Brockton, MA. Type: Full Time Flex Shift:… more
- Brockton Hospital (Brockton, MA)
- Registered Nurse (RN) Job, Part Time...a healing, humane, and caring environment. + Research: uses clinical inquiry in practice + Resource Utilization : ... Signature Healthcare's Brockton Hospital is hiring for a Part Time Flex Nights Registered Nurse (RN) in Brockton, MA. Type: Part Time Flex Shift: Nights A New… more
- Evolent (Providence, RI)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Dana-Farber Cancer Institute (Foxborough, MA)
- …degree required, one of which must be in Nursing. Licensed as a Registered Nurse in the Commonwealth of Massachusetts. Hematology-Oncology experience required. ... 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)
- …primary responsibilities. EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It ... include the development and supervision of staff (RNs, LPN's,SWs and non- clinical support), evaluation and maintenance of case management skills and outcomes,… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... Resource Management; Continuum of Care Management (Discharge planning) and Clinical Documentation Management. Collects data via utilization ...residency if that state is a member of the Nurse Licensure Compact. Five (5) years of clinical… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... Resource Management; Continuum of Care Management (Discharge planning) and Clinical Documentation Management. Collects data via utilization ...residency if that state is a member of the Nurse Licensure Compact. Five (5) years of clinical… more
- Point32Health (Canton, MA)
- …Qualifications - what you need to perform the job Certification and Licensure + Registered Nurse with current unrestricted license in state of residence + May ... wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager possesses strong clinical knowledge, critical… more
- Highmark Health (Providence, RI)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- University Medicine (East Providence, RI)
- …endoscopy population of Brown Medicine under the direct supervision of a registered nurse (RN). PRINCIPAL DUTIES AND RESPONSIBILITIES: Consistently applies the ... cleaning and disinfection of equipment. + Demonstrates strong understanding and utilization of infection prevention practices. + Maintains appropriate levels of… more
- Brockton Hospital (Brockton, MA)
- …current license from Commonwealth of Massachusetts to practice as a Registered Nurse . Minimum of five years clinical experience in an acute care facility ... primary care physicians (PCP's) as well as other hospital clinical and administrative staff to develop and implement effective...required. Prior experience in case management, utilization review or discharge planning… more