- Cognizant (Concord, NH)
- …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
- 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 ... the medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized… more
- CVS Health (Concord, NH)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules...will include weekends, holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to… more
- Fresenius Medical Center (Lowell, 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
- Fresenius Medical Center (Lowell, 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
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- …of the EDRP application. Former EDRP participants ineligible to apply. Responsibilities This Registered Nurse - Community Living Center (CLC) is located in the ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- HCA Healthcare (Manchester, NH)
- …Do you have the PRN career opportunities as a(an) PRN House Supervisor RN Registered Nurse you want with your current employer? We have an exciting ... want to work as a(an) PRN House Supervisor RN Registered Nurse where your passion for creating...meetings with hospital staff to identify and communicate bed utilization issues . With inpatient coordinators and clinical… more
- Humana (Concord, NH)
- **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
- Atrius Health (Chelmsford, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... health and welfare benefit package. **Job:** **Nursing* **Organization:** **Pediatrics* **Title:** * Registered Nurse (MNA) Pediatrics - Chelmsford - Part time… more
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- Summary This Registered Nurse - Clinical Nurse Coordinator position is located in the Office of Community Care at the Brady Sullivan Tower Building in ... Possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, ...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Lawrence General Hospital (Methuen, MA)
- …contracted by the hospital and being held accountable for appropriate financial and clinical outcomes of these patients. The RN Care Coordinator will be assigned to ... of the Hospital on a rotating basis to perform utilization reviews and other UM activities, as needed, to...to reduce the possibility of reimbursement denials * Provides clinical information necessary for authorization to 3rd parties within… 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 ... list. Other duties and responsibilities may be assigned. 1.Collaborates with PHO clinical leadership and conduct root cause analysis to identify rising and… more
- Evolent (Concord, NH)
- …+ 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
- Lawrence General Hospital (Methuen, MA)
- …The RN Care Manager collaborates with physicians, nurses, and other clinical staff/directors to coordinate, facilitate and expedite patient care services across ... with attending MD to reduce possibility of reimbursement denials + Provides clinical information necessary for authorization to 3rd parties within one business day… more
- Fresenius Medical Center (Medford, MA)
- …of staff as assigned. + Performs and sets-up in-services regarding equipment, supplies and clinical for all staff. + Coordinates all aspects of patient care with the ... Policies. + Participates in cost control initiatives. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Tufts Medicine (Lowell, MA)
- …(4 Hours)** **Job Description** **Minimum Qualifications:** 1.Current licensure as a Registered Nurse or Physical Therapist. 2. Massachusetts RN Licensure ... Life Support (BLS) Certification **Preferred Qualifications:** 1. Bachelor's prepared level preferred- Registered Nurse BSN preferred, or Physical Therapist with… more
- Tufts Medicine (Lowell, MA)
- …**Job Description** **Minimum Qualifications** **:** 1. Current licensure as a Registered Nurse or Physical Therapist. **Preferred Qualifications** **:** 1. ... Bachelor's prepared level preferred- Registered Nurse BSN preferred, or Physical Therapist...as interviewing, hiring, and disciplinary action. + Promotes efficient utilization of resources to achieve desired clinical … more
- Beth Israel Lahey Health (Burlington, MA)
- …to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure, ... of Ethics, the Case Manager performs duties relative to utilization and discharge planning. The Complex Case Manager acts...Must hold current Commonwealth of Massachusetts license as a Registered Nurse , and Basic Life Support (BLS)… more
- HCA Healthcare (Derry, NH)
- …compact state Registered Nurse license + Two or more years of clinical experience. + Case Management, Utilization & Managed Care experience and 1 or more ... care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care,...supporting a balance of optimal care and appropriate resource utilization . + The RN Case Manager Team Lead will… more
- Highmark Health (Concord, NH)
- …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