- 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
- 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
- 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
- CVS Health (Concord, NH)
- …+ 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
- 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
- Dartmouth Health (Hampstead, NH)
- …Manages the matrix relationships, including but not limited to providing input and feedback to Nurse Educators, Clinical Nurse Specialists, and Clinical ... Clinical or professional certification preferred. Required Licensure/Certifications - Licensed Registered Nurse with New Hampshire eligibility. - Current BLS… 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
- 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
- Tufts Medicine (Nashua, NH)
- …direction of physicians, mid-level practitioners, and may work under the direction of registered nurses depending on their unit. A clinical technologist role ... outpatient/ambulatory setting. The position is a patient liaison through both clinical and administrative responsibilities. This position plays an important role in… more