- Cognizant (Boston, MA)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… 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 ... the medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized… more
- Fresenius Medical Center (Lowell, MA)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Fresenius Medical Center (Peabody, MA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Fenway Health (Boston, MA)
- Registered Nurse , Per Diem Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Part-time Description As a ... Registered Nurse (RN) at Fenway Health you...harm reduction, behavioral health integration, and team-based care. The nurse serves in a clinical leadership role… more
- Atrius Health (Peabody, MA)
- …Department Chief, Nurse Leader or designee, this registered professional nurse provides practice support to a clinical team, recognizing the patient as ... and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Peabody - Full… more
- Beth Israel Lahey Health (Cambridge, MA)
- …high reliability processes to reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...outliers, compiling reports and serving as the liaison with clinical stakeholder and clinical committees in sharing… more
- Beth Israel Lahey Health (Boston, MA)
- …focusing on the delivery of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a safe and ... The RN Case Manager must be adept at driving throughput metrics, clinical effectiveness, and fiscal responsibility. **Job Description:** Essential Functions: The RN… more
- Tufts Medicine (Melrose, MA)
- …to review patient records, analyze data, and identify practice and patient outlier utilization , and gaps in quality measures for weekly practice and medical director ... list. Other duties and responsibilities may be assigned. 1.Collaborates with PHO clinical leadership and conduct root cause analysis to identify rising and… more
- Lawrence General Hospital (Methuen, MA)
- …contracted by the hospital and being held accountable for appropriate financial and clinical outcomes of these patients. The RN Care Coordinator will be assigned to ... of the Hospital on a rotating basis to perform utilization reviews and other UM activities, as needed, to...to reduce the possibility of reimbursement denials * Provides clinical information necessary for authorization to 3rd parties within… more
- Evolent (Boston, MA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Lawrence General Hospital (Methuen, MA)
- …The RN Care Manager collaborates with physicians, nurses, and other clinical staff/directors to coordinate, facilitate and expedite patient care services across ... with attending MD to reduce possibility of reimbursement denials + Provides clinical information necessary for authorization to 3rd parties within one business day… more
- Fresenius Medical Center (Medford, MA)
- …of staff as assigned. + Performs and sets-up in-services regarding equipment, supplies and clinical for all staff. + Coordinates all aspects of patient care with the ... Policies. + Participates in cost control initiatives. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- North Shore Community Health (Gloucester, MA)
- …The Primary Care Team Nurse Care Manager (PC team RN CM) is a registered nurse whose primary responsibility is managing a panel of patients on an assigned ... PC team RN CM coordinates the overall health care utilization for NSCH's most vulnerable patients. The Organization North...Perform nurse visits independently and within the registered nurse scope of practice outlined by… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Qualifications:** 1. Bachelor's degree preferred. 2. Current Massachusetts state license as a Registered Nurse (RN). 3. Two years of recent acute hospital ... with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …and administrative staff at all levels of the organization. Education and Experience: + Registered nurse with BSN and 3-5 years in a managed care health ... concerns that may require additional attention. + Partner with Utilization and Care Management to provide clinical ...with Utilization and Care Management to provide clinical support and analysis on high-cost members. + Assist… more
- Tufts Medicine (Lowell, MA)
- …(4 Hours)** **Job Description** **Minimum Qualifications:** 1.Current licensure as a Registered Nurse or Physical Therapist. 2. Massachusetts RN Licensure ... Life Support (BLS) Certification **Preferred Qualifications:** 1. Bachelor's prepared level preferred- Registered Nurse BSN preferred, or Physical Therapist with… more
- Tufts Medicine (Lowell, MA)
- …**Job Description** **Minimum Qualifications** **:** 1. Current licensure as a Registered Nurse or Physical Therapist. **Preferred Qualifications** **:** 1. ... Bachelor's prepared level preferred- Registered Nurse BSN preferred, or Physical Therapist...as interviewing, hiring, and disciplinary action. + Promotes efficient utilization of resources to achieve desired clinical … more
- Deloitte (Boston, MA)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
- Beth Israel Lahey Health (Boston, MA)
- …Nursing Program required. Baccalaureate degree in Nursing strongly preferred. + License Registered Nurse required. + American Heart Association - Basic Life ... Emergency Department. In absence of Admission Facilitator, directs bed utilization . + Provides clinical consultation, support, education...in the evaluation of staff as requested by the nurse manager. + Rounds on the clinical … more