- Children's Hospital Boston (Boston, MA)
- …Planning and or Utilization Management ) preferred. Office/Site Location:BostonRegular, Temporary, Per Diem:Per Diem Remote Eligibility :Onsite Only ... 74825BRJob Posting Title: Registered Nurse Case Manager, Inpatient &...per Week:1 Job Posting Category:NursingJob Posting Description:The Per Diem RN Case Manager (inpatient and/or ambulatory) will be responsible… more
- Highmark Health (Boston, MA)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Atrius Health (Boston, MA)
- …Clinical Director, Nurse Leader or designee, the professional licensed registered nurse provides patient centric, after-hours phone and/or telehealth support ... records system required. *REQUIRED HOURS:* * * *Full time remote Pedi RN 3pm-11:30pm AND 3.0 FTE...Avaya phone system, Outlook, QGenda scheduling, and pdf documentation management . . Remote workers must adhere to… more
- Guardian Life (Boston, MA)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Beth Israel Lahey Health (Wakefield, MA)
- …Facility experience preferred. + Active, unrestricted Massachusetts Registered Nurse License required. Certification in Case Management (CCM) preferred. ... making a difference in people's lives.** The Care Manager, RN provides care management services to the...behavior. Working with the healthcare team, the Care Manager, RN monitors appropriate utilization of healthcare resources,… more
- Humana (Boston, MA)
- …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... project management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals +… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be ... based on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into CES (Claims Editing System)… more