- Commonwealth Care Alliance (Boston, MA)
- … Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... conducting centralized clinical review and authorization creation for centrally-authorized services. This position has a key role in ensuring CCA meets CMS… more
- Lincoln Financial Group (Boston, MA)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Veterans Affairs, Veterans Health Administration (Bedford, MA)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA offers a comprehensive total rewards ... package: VA Nurse Total Rewards This is an open continuous announcement...education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic… more
- State of Massachusetts (Boston, MA)
- …and service provision, and effective internal quality reviews. Additionally, the AL Unit Nurse will review and evaluate reports with potentially related clinical ... ALRs through directing and supervising AL Unit intake and review of such submissions. The AL Unit Nurse...and determining the ALR's compliance with the regulations, the utilization of existing policies and practices that promote Resident… more
- Fallon Health (Worcester, MA)
- …in the region. **Responsibilities** **R** **esponsibility Summary:** Serves as a float Nurse Practitioner (NP) to each of the Summit ElderCare sites throughout ... documentation of all services provided according to professional + Identifies utilization and service delivery problems and participates in their + Participates… more
- Cambridge Health Alliance (Cambridge, MA)
- …team leader in multi-disciplinary team discussion regarding treatment planning, treatment review , quality assurance and utilization review ... Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry...authorizing practice in an expanded role as a Psychiatric Nurse Clinical Specialist and authorization including prescriptive authority. _In… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... point-of-care testing, treatments, and lab and diagnostic test result review + Provides timely and informed patient triage +...shifts on a rotating basis. Required Qualifications: + Registered Nurse License in MA + Bachelor's degree in Nursing… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …engagement in self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and provides ongoing ... point-of-care testing, treatments, and lab and diagnostic test result review + Documents patient care, ongoing evaluation, patient progress/risk status,… more
- Fresenius Medical Center (Medford, MA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …Aide's responsibility is to provide clinical and administrative support to the Home Health Utilization Nurse , the Transition of Care Nurse and the agencies ... to track patients and their services. + Escalate concerns to Home Health Utilization Nurse appropriately. + Performs general clerical duties, including document… more
- State of Massachusetts (Boston, MA)
- …an experienced and dynamic Clinical Supervisor of Ambulatory Care Services, Registered Nurse V.The Clinical Supervisor of Ambulatory Care Services is responsible for ... DDS, shelters, and the community, the Clinical Supervisor ensures the effective utilization of resources to enhance patient care. This role encompasses the oversight… more
- Tufts Medicine (Burlington, MA)
- …(ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management, utilization review , denials management, or progressive leadership in an ... other Quality indicators where indicated. 10. Collaborates with case management and utilization review team to ensure that documentation is clearly substantiated… more
- Beth Israel Lahey Health (Milton, MA)
- …Manager demonstrates clinical expertise in the development of discharge plans, applies utilization review criteria to determine medical necessity and advocates ... a related field + Current licensure as a registered nurse in the State of Massachusetts + Minimum of...prior experience in Case Management, preferred (Discharge Planning and Utilization Review + Current knowledge of federal,… more
- GE Vernova (Foxborough, MA)
- …+ Hold operating rhythm, pacing calls on Resource/workload management, Engineering utilization , Budget Deviation, On Time Delivery (OTD), Say Do Ratio (SDR), ... Customer comments. + Collaborate with Project Controls to have monthly rhythm to review workload vs capacity and work with department managers on their respective… more
- Beth Israel Lahey Health (Milton, MA)
- …level nursing experience (eg, ER, ICU) or equivalent case management, quality, or utilization review in a hospital setting Skills, Knowledge, and Abilities + ... CDI team of clinicians, coding professionals, physicians, physician's assistants' and nurse practitioners to ensure accurate and timely clinical documentation in the… more
- Tufts Medicine (Boston, MA)
- …providers who are absent, etc.) by making continual adjustments in room utilization and assignment. 2. Prepares medical record for patient visit, confirming accuracy ... arranging for diagnostic testing, surgery and in-patient admissions under direction of the nurse or physician. 14. Assists with patient billing by ensuring CPT code,… more
- Dana-Farber Cancer Institute (Boston, MA)
- …practitioner group consisting of physicians, physician's assistants, program nurses and nurse practitioners and other care providers, the individuals in this ... the assigned patient population to achieve patient safety, flow and resource utilization goals of the organization and sponsoring agencies; + Responsible for… more
- Tufts Medicine (Boston, MA)
- …providers who are absent, etc.) by making continual adjustments in room utilization and assignment. 2. Prepares medical record for patient visit, confirming accuracy ... arranging for diagnostic testing, surgery and in-patient admissions under direction of the nurse or physician. 14. Assists with patient billing by ensuring CPT code,… more
- Harvard University (Cambridge, MA)
- …in clinical management, supervision, quality assurance, continuous improvement, utilization management, and understanding complex organizational, financial, and ... and/or visa sponsorship. + This position has a 90-day orientation and review period. Total Rewards: Harvard's Total Rewards Program is designed to attract,… more
- Harvard University (Cambridge, MA)
- …+ This position has a 90-day orientation and review period. Department:Urgent CarePre-Employment Screening:Criminal, Education, IdentitySchedule: Schedule Week ... projects, daily huddles, Lean activities, and other continuing education, utilization management, and other departmental activities. + Fosters positive working… more