- Humana (Providence, RI)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …The Clinical Care Manager (CCM) provides, coordinates, and organizes evidence-based care management to chronic disease patients, especially to those who are most at ... patients receive optimal care including acute illness and chronic disease management , education about lifestyle and behavior modification, and preventive care across… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …Clinical Care Manager (CCM) provides, coordinates, and organizes evidence-based care management to Medical Assistant Treatment Program (MAT) patients. As an employer ... patients receive optimal care including acute illness and chronic disease management , education about lifestyle and behavior modification, and preventive care across… more
- Evolent (Providence, RI)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This RN-Interventional Radiology position is ... Providence location. This position is full-time at 40 hours per week. The Nurse Interventional Radiology (IR) Registered Nurse (RN) is responsible for providing… more
- Evolent (Providence, RI)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies and ... behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a...and regulations. * Practices and maintains the principles of utilization management and appeals management … more
- GE Vernova (Foxborough, MA)
- …expeditor of actions. + Hold operating rhythm, pacing calls on Resource/workload management , Engineering utilization , Budget Deviation, On Time Delivery (OTD), ... Customer comments. + Collaborate with Project Controls to have monthly rhythm to review workload vs capacity and work with department managers on their respective… more