- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- Beth Israel Lahey Health (Burlington, MA)
- …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management team ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
- Fenway Health (Boston, MA)
- …MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing Job Type Full-time Description As a Registered Nurse ( RN ) at Fenway Health ... patient, and other care team members. + Influences appropriate utilization of healthcare resources by helping to coordinate patient...+ Education: Associate degree in nursing + Current Massachusetts Registered Nurse ( RN ) license degree… 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 ... requesting an out-of-area referral. **Job Description** **Minimum Qualifications:** 1. Massachusetts RN Licensure. 2. Five (5) years of experience in acute hospital… more
- Fresenius Medical Center (Medford, MA)
- …Policies. + Participates in cost control initiatives. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... Desk Coordinator) **EDUCATION:** + Graduate of an accredited School of Nursing ( RN ) + Current appropriate state licensure and ACLS certification. + ASC certification… more
- Fresenius Medical Center (Peabody, MA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Fresenius Medical Center (Lowell, MA)
- …supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... combination of education and experience + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + 6 - 8… more
- Massachusetts Institute of Technology (Cambridge, MA)
- Registered Nurse , Care Coordinator + Job Number: 25320 + Functional Area: Health Care + Department: MIT Health + School Area: Executive Vice President + Pay ... Email a Friend Save Save Apply Now Posting Description REGISTERED NURSE , CARE COORDINATOR, MIT Health, will...Graduate of an accredited nursing program; bachelor's degree; current RN license in Massachusetts; CPR Certified; a minimum of… more
- Atrius Health (Somerville, MA)
- …and welfare benefit package. **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** * Registered Nurse (MNA) Internal Medicine - Somerville - Full ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience. Experience with an electronic medical records system… more
- Atrius Health (Boston, MA)
- …health and welfare benefit package. **Job:** **Nursing* **Organization:** **Nephrology* **Title:** * Registered Nurse (MNA) Nephrology - Kenmore - Per diem* ... *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional...specialty. *EXPERIENCE* Strongly prefer minimum of 2 years of RN experience. Experience with an electronic medical records system… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by leading the ... on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of...reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts,… more
- Beth Israel Lahey Health (Boston, MA)
- …you're not just 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 ... the hospitalized patient. Together with the medical provider, the RN Case Manager collaborates with all members of the...of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a… more
- Lawrence General Hospital (Methuen, MA)
- Job Description: The RN Care Coordinator is responsible for overseeing the appropriateness of care provided to members of health plans contracted by the hospital and ... appropriate financial and clinical outcomes of these patients. The RN Care Coordinator will be assigned to selected areas...of the Hospital on a rotating basis to perform utilization reviews and other UM activities, as needed, to… more
- Lawrence General Hospital (Methuen, MA)
- …below the top of the range to support future salary growth. The RN Care Manager collaborates with physicians, nurses, and other clinical staff/directors to ... acute care setting with discharge planning, continuing care, care management, and utilization review preferred. + Strong verbal and written communications skills +… more
- Cambridge Health Alliance (Cambridge, MA)
- …**Work Days** : Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category** : Registered Nurse **Department** : Inpatient Case Management CH **Job Type** ... RN Case Manager - Inpatient Case Management CH...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Intermountain Health (Boston, MA)
- …of Intermountain Health, and abide by service behavior standards. **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice. + ... **Job Description:** The RN Ambulatory Care Manager I delivers comprehensive ambulatory...Conducts root cause analysis of extended post-acute stays, inappropriate utilization , readmissions, and tracks key data elements or metrics.… more
- Cambridge Health Alliance (Everett, MA)
- …**Work Days** : Mon - Friday and Rotating Weekends/Holiday **Category** : Registered Nurse **Department** : Inpatient Case Management Everett **Job Type** ... RN Case Manager - Inpatient Case Management Everett...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Cambridge Health Alliance (Somerville, MA)
- …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job ... RN Case Manager - Inpatient Case Management SH...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Humana (Boston, MA)
- …**Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin, including compact license. + Two ... community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the… 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 ... are currently hiring a Clinical Care Manager - OBAT RN based in Framingham. As part of a team-based...self-care, decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care and… more
