- Humana (Concord, NH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in ... and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management … more
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities This Registered Nurse position is located in the Surgical Clinic at...and coaching on wellness, disease prevention, and chronic care management . Manages secure messaging to facilitate care coordination. Assists… more
- Beth Israel Lahey Health (Wakefield, MA)
- …Skilled Nursing Facility experience preferred. + Active, unrestricted Massachusetts Registered Nurse License required. Certification in Case Management (CCM) ... making a difference in people's lives.** The Care Manager, RN provides care management services to the BILHPN primary care physicians focusing on at risk, high… more
- Evolent (Concord, NH)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more
- Lawrence General Hospital (Lawrence, MA)
- …Works collaboratively with the Complex Care Nurse Managers, Social Workers, and Utilization Review Nurses, in coordinating and providing care that is safe, ... . + Provides administrative, technical, and direct support to Complex Care Nurse Managers; complete admission patient interviews and care needs assessment, collect,… more
- Evolent (Concord, NH)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies and ... behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...and regulations. * Practices and maintains the principles of utilization management and appeals management … more
- Erickson Living (Peabody, MA)
- …clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management /Safety ... clinical practice and processes in accordance with the Erickson Senior Living Management Policies and Procedures and nursing standards of practice. + Ownership of… more
- Intermountain Health (Concord, NH)
- …of 2 years' experience in acute clinical nursing setting + Knowledge of utilization management and case management principles preferred KNOWLEDGE, SKILLS, ... **Job Description:** The Pre-Access Prior Authorization RN provides timely review of authorization requests and/or review of denials to ensure medical necessity,… more
- Erickson Living (Peabody, MA)
- …loss, and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management /Safety (PI/RM/S) ... a plus. + Minimum 3 years' experience in a healthcare leadership role (Charge Nurse , Unit Manager, etc.). + Experience with an electronic medical record (EMR) system… more