- Evolent (Providence, RI)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Fallon Health (Worcester, MA)
- …any other additional meetings when required. + Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director. + Assumes the role of ... therapeutic interventions. + Participates in the development and ongoing review of each participant's care plan. + Delegates and...triage nurse per the direction of the Clinical Nurse Manager or Site Director. +… more
- Cardinal Health (Providence, RI)
- …both scheduled outbound calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse , Individualized Care to discuss feedback ... who need them-faster.** **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties… more
- Oracle (Providence, RI)
- …+ Excellent communication, stakeholder engagement, and leadership skills. **Preferred Qualifications:** + Clinical experience as a nurse or physician with a deep ... **Job Description** The Clinical Note AI Agent Product Management Leader will...Gather and analyze information to define product specifications and review design specifications. Envision and communicate product strategy and… more
- Fallon Health (Worcester, MA)
- …relevant clinical information from medical care providers as needed for the clinical review process * Conducts pre-authorization and concurrent clinical ... Twitter and LinkedIn. **Brief summary of purpose:** The PA Nurse uses a multidisciplinary approach to review ...review according to policy and procedure * Documents clinical , functional, psychosocial information in the Core System as… more
- Fallon Health (Worcester, MA)
- …Record Information (CORI) results and reliable transportation **Experience:** *1+ years of clinical experience as a Registered Nurse managing chronically ill ... the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge,… more
- Humana (Providence, RI)
- …a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record ... complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently... clinical and coding experience to conduct a clinical validation review of the inpatient medical… more
- Trinity Health (Stafford Springs, CT)
- …DEADLINE - December 31, 2025** At **Johnson Memorial Hospital** the **Student Nurse Internship (SNI)** is an intensive 8-week summer program. **Program starts May ... **What you will do** + Work alongside a registered nurse in an assistive role + Will observe and...in educational activities designed to reinforce learning in the clinical practice environment **Minimum Qualifications** + Be entering the… more
- Brown University (Providence, RI)
- Job Description: Position Purpose: The Research Nurse Practitioner (NP) will provide medical support to research studies. The primary functions of this position are ... conduct support activities related to these duties. The Research NP will review medical histories with research participants, perform a physical examination to… more
- BioLife Plasma Services (Attleboro, MA)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife Plasma Services is a subsidiary of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- National Health Care Associates (Stafford Springs, CT)
- …with research-backed wound care and cleansing products + Certified Wound Care Nurse (CWCN) Certification preferred + Strong clinical assessment, organizational, ... to join our team! **-** **What You'll Do:** As the Wound Care Nurse , you'll be responsible for assessing, treating, and monitoring wound conditions in collaboration… more
- Highmark Health (Providence, RI)
- …:** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support ... compliance with nationally recognized quality initiatives and the network's clinical process improvement and patient safety initiatives. The incumbent requires… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …sites to support this growth. We are currently hiring a Primary Care Registered Nurse based in Worcester MA. The Registered Nurse collaborates with the health ... patients' family members, serve as a member of the clinical practice team and work collaboratively with other team...care outside the organization by activities including medication management, review of diagnostic test results, and follow up on… more
- Datavant (Providence, RI)
- …realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role ... Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients. + Demonstrate understanding of… more
- Athena Health Care Systems (Worcester, MA)
- We are hiring a Regional MDS Nurse to join our team in Worcester County! This is an on-site position with weekly pay ranging from $55 to $65 an hour, depending on ... are nurtured to allow you to grow within the company. The regional clinical reimbursement specialist provides support and coverage assistance related to MDS and the… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …team is expanding across sites to support this growth. We're hiring a Registered Nurse for our Primary Care Clinic in Milford, MA who collaborates with the ... emotional support to patients' families, and working collaboratively with the clinical practice team. They also participate in coordinating care, support… more
- BioLife Plasma Services (Worcester, MA)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife Plasma Services is a subsidiary ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Prime Healthcare (Woonsocket, RI)
- …The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive ... admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license2. Grandfathered prior to April 1, 2015. Minimum… more
- Prime Healthcare (Woonsocket, RI)
- …The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive ... admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license + Grandfathered prior to April 1, 2015.… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …Special Needs Unit Program Director maintains direct oversight of the clinical and administrative operations of Westborough Behavioral Healthcare Hospitals' Child ... establishing a strong child behavioral health model that guides the program's clinical framework and service provision. Shift details: Full-time 40 hours per week… more