- Beth Israel Lahey Health (Burlington, MA)
- …a difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts +… more
- Beth Israel Lahey Health (Burlington, MA)
- …Weekend Rotation **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts +… more
- Beth Israel Lahey Health (Burlington, MA)
- …in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case ... Clinic inpatient admissions. Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… 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 ... and educate to improve outcomes. 8. Assists with preparation and presentation of utilization review monitoring/trending reports for review with physicians… more
- Children's Hospital Boston (Boston, MA)
- …Hours per Week:40 Job Posting Category:NursingJob Posting Description:The Utilization Review Nurse will be ... with established procedures, guidelines and criteria + Focusing on high priority utilization review activity including: conducting emergency admission level of… more
- Brockton Hospital (Brockton, MA)
- …responsibilities. EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It is ... delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare… more
- Tufts Medicine (Lowell, MA)
- …with EVD, IABP and Impella patients. The Clinical Leader of ICU-G is a Registered Nurse with responsibility and accountability for the coordination of clinical ... expectations, continuing education, credentialing, performance appraisals, auditing, concurrent monitoring, utilization review , risk management and active problem… more
- CenterWell (Pittsfield, MA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Healthfirst (MA)
- …in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management. + Demonstrated ... process + Additional duties as assigned Minimum Qualifications: + RN , LPN OR Dental Hygienist Preferred Qualifications: +...understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual,… more
- Erickson Living (Peabody, MA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... (skilled nursing, long term care, assisted living or hospital) is required.** + Current Registered Nurse license for the state in which they operate. + Current… more
- Tufts Medicine (Lowell, MA)
- …in clinical practice and customer satisfaction, while striving for optimal efficiency, productivity and utilization of all RN staff to meet the needs of the ... This is great opportunity for an experienced Emergency Services RN that is ready to take the first step...this role you will work closely with the Clinical Nurse Manager in supporting the shared vision for the… more
- Veterans Affairs, Veterans Health Administration (Bedford, MA)
- …program office after complete review of the EDRP application. Responsibilities The Registered Nurse position is located in Nursing, Mental Health at the ... total rewards package: VA Nurse Total Rewards The Inpatient Mental Health (MH) Registered Nurse ( RN ) provides and leads the provision of competent,… more
- Beth Israel Lahey Health (Cambridge, MA)
- …needs throughout the spectrum of life, from pediatrics to older adults. **Job Description:** Registered Nurse - Sign on Bonus eligibility up to $12,000 **Primary ... lives.** Join our team as a key Emergency Department nurse in our renovated and expanded department, caring for...c. Maintains BLS, ACLS certification d. Attends Emergency Department RN Competency Review Course annually. e. Attends… more
- Tufts Medicine (Lowell, MA)
- …etc.) **Job Description** **Minimum Qualifications:** 1. Bachelor's degree in Nursing (BSN). 2. Registered Nurse ( RN ) license. 3. Basic Life Support (BLS) ... **_Tufts Medicine has a new Community RN Career Pathway plan_** that allows you to...customer satisfaction, while striving for optimal efficiency, productivity, and utilization of all resources. Provides patient and staff education,… 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
- Baystate Health (Springfield, MA)
- **Hospital Case Manager** Per Diem The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial ... and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers… more
- Beth Israel Lahey Health (Newburyport, MA)
- …experience in the acute care setting and previous case management experience, utilization review and/or discharge planning experience is required. **Required ... case load based on patient and hospital need. Concurrently review 's patient treatment plan and progress to ensure that...Licensures/Certifications:** Must be currently licensed as a Registered Nurse by the Commonwealth of Massachusetts.… more
- Evolent (Boston, MA)
- …+ Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of ... direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + Cardiology and Oncology Healthcare… more
- Erickson Living (Hingham, MA)
- …of medical practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that ... + Researches and selects care options as appropriate. The nurse care coordinator may utilize a range of alternative,...available. **What you will need** + Active Professional Licensed RN required. CCM certification or working toward. + Minimum… more