- 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
- 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
- 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 (Chelmsford, MA)
- …health and welfare benefit package. **Job:** **Nursing* **Organization:** **Pediatrics* **Title:** * Registered Nurse (MNA) Pediatrics - Chelmsford - Part time ... *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 (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
- 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
- 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
- Intermountain Health (Boston, MA)
- …of Intermountain Health, and abide by service behavior standards. **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice. + ... **Job Description:** The RN Ambulatory Care Manager I delivers comprehensive ambulatory...Conducts root cause analysis of extended post-acute stays, inappropriate utilization , readmissions, and tracks key data elements or metrics.… 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
- Humana (Boston, MA)
- …**Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin, including compact license. + Two ... community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the… 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
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …may require evening, weekend and/or holiday shifts on a rotating basis. Job Requirements: + Registered Nurse License in MA + 1-2 years of clinical experience + ... increase patient engagement, reduce risk, and minimize hospital and ER utilization . + Identifies, manages, and coordinates patient care, providing ongoing… 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
- Atrius Health (Boston, MA)
- …Connecting. Growing together.* **SUMMARY** Under direction of the department chief, nurse leader or designee, this registered professional nurse ... direct patient care to patients, according to established guidelines. The Special Procedure nurse performs a variety of complex tasks which may include assisting in… 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
- Deloitte (Boston, MA)
- …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, clinical documentation… more
