- 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 (Boston, MA)
- …Demonstrates professional commitment and is responsible for ensuring patient safety. **Resource Utilization ** + The registered nurse considers factors ... just taking a job, you're making a difference in people's lives.** Operating Room (OR) Registered Nurse - New England Baptist Hospital Full Time Operating room … 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
- Tufts Medicine (Melrose, MA)
- …to review patient records, analyze data, and identify practice and patient outlier utilization , and gaps in quality measures for weekly practice and medical director ... requesting an out-of-area referral. **Job Description** **Minimum Qualifications:** 1. Massachusetts RN Licensure. 2. Five (5) years of experience in acute hospital… 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
- Atrius Health (Boston, MA)
- …Under the direction of the Department Chief Physician and Nursing Supervisor, this Registered Nurse position is responsible for effective care delivery and ... health and welfare benefit package. **Job:** **Nursing* **Organization:** **Cardiology* **Title:** * Registered Nurse (MNA) Cardiology - Kenmore - Full time… more
- Atrius Health (Watertown, MA)
- …and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Watertown - 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
- Fallon Health (Worcester, MA)
- …degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of ... three to five years clinical experience as a Registered Nurse in a clinical setting required....clinical setting required. * 2 years' experience as a Utilization Management/Prior Authorization nurse in a managed… 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 (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
- 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
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …require evening, weekend and/or holiday shifts on a rotating basis. Required Qualifications: + Registered Nurse License in MA + Bachelor's degree in Nursing from ... are currently hiring a Clinical Care Manager - OBAT RN based in Framingham. As part of a team-based...self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and… 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
- Intermountain Health (Boston, MA)
- …/Professional Nursing program. + Required Licensure/Certification: State licensure as a Registered Nurse ( RN ). Preferred Qualifications + Bachelor's ... cost-effective outcomes. Provides focused support to various areas such as utilization management, emergency department, acute, ambulatory and specialty care. Please… 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