- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- CVS Health (Woonsocket, RI)
- …+ 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
- Beth Israel Lahey Health (Boston, MA)
- …taking a job, you're making a difference in people's lives.** The RN Case Manager working in the Triad Model of Care Transitions partners with the interdisciplinary ... patient. Together with the medical provider, the RN Case Manager collaborates with all members of the care team,...of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a… more
- Fresenius Medical Center (Providence, RI)
- …care pre, during and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques ... and physical structure of the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment in the vascular access… more
- Fallon Health (Worcester, MA)
- …degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of ... three to five years clinical experience as a Registered Nurse in a clinical setting required....clinical setting required. * 2 years' experience as a Utilization Management/Prior Authorization nurse in a managed… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... or designee. Provides coordinated care support to Physician leadership and Clinical Manager (s) of respective services. Makes daily rounds and collaborates with the… more
- Charter Care Health Partners (North Providence, RI)
- …Graduate of a School of Nursing (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode Island or in the nurse 's ... or designee. Provides coordinated care support to Physician leadership and Clinical Manager (s) of respective services. Makes daily rounds and collaborates with the… more
- Intermountain Health (Boston, MA)
- …Health, and abide by service behavior standards. **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice. + Bachelor ... **Job Description:** The RN Ambulatory Care Manager I delivers comprehensive ambulatory care management services to identified patients. Leveraging clinical… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …may require evening, weekend and/or holiday shifts on a rotating basis. Job Requirements: + Registered Nurse License in MA + 1-2 years of clinical experience + ... this growth. We are currently hiring a Clinical Care Manager based in Milford, MA. The Clinical Care ...patient engagement, reduce risk, and minimize hospital and ER utilization . + Identifies, manages, and coordinates patient care, providing… 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 ... this growth. We are currently hiring a Clinical Care Manager - OBAT RN based in Framingham. As part...self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and… more
- Deloitte (Boston, MA)
- …clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN, Quality, ... degree in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist… more
- Beth Israel Lahey Health (Boston, MA)
- …are not fit for duty. Participates in the evaluation of staff as requested by the nurse manager . + Rounds on the clinical units to assess and address patient ... Nursing Program required. Baccalaureate degree in Nursing strongly preferred. + License Registered Nurse required. + American Heart Association - Basic Life… more
