- VitalCore Health Strategies (Hopkinton, MA)
- …Animal/Pet Insurance Employee Assistance Program and Discount Center 401K EEO Keywords: Utilization Management , RN , Nurse , Administrative, #INDMA ... in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the...of an accredited School of Nursing Licensure as a Registered Nurse in the state of employment… more
- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Woonsocket, RI)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… more
- Baystate Health (Springfield, MA)
- …- $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The ** RN Hospital Case Manager** is a registered nurse responsible for the ... MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate +… more
- CenterWell (Providence, RI)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- Beth Israel Lahey Health (Cambridge, MA)
- …SKILLS, AND ABILITIES REQUIRED** 1. RN with experience in risk management , quality assessment, or utilization management . 2. Strong spreadsheet, ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of… 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 ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… 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 ... + Schedule: + Pay Grade: 9 Email a Friend Save Save Apply Now Posting Description REGISTERED NURSE , CARE COORDINATOR, MIT Health, will serve as a core member of… more
- Beth Israel Lahey Health (Burlington, MA)
- …to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure, ... Must hold current Commonwealth of Massachusetts license as a Registered Nurse , and Basic Life Support (BLS)...of medical/surgical nursing care experience. Two years of case management or utilization management experience… more
- Trinity Health (Springfield, MA)
- …affiliated nursing program. BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS ... **Shift:** Day Shift **Description:** At **Mercy Medical Center** our ** RN Inpatient Care Coordinators** are responsible for coordinating patient...(AHA/ARC). Certification in Case Management (ACM, CCM) required within one year of employment… more
- Baystate Health (Springfield, MA)
- …to this role. **Education:** Bachelors Degree in Nursing (Required) **Certifications:** Registered Nurse - State of MassachusettsState of MassachusettsState of ... - Midpoint - Maximum $46.22 - $53.13 - $62.85 ** RN , Patient Placement Bed Manager** **Part Time - 24...outlined in the evidence based practice guidelines + Uses Utilization Analysis / Management principles, insures that patient's… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. * 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. * ... degree in nursing required **License/Certifications:** Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience:** * A minimum of… more
- Lawrence General Hospital (Methuen, MA)
- …experience in an acute care setting with discharge planning, continuing care, care management , and utilization review preferred. ? Strong verbal and written ... Job Description: The RN Care Coordinator is responsible for overseeing the...of the Hospital on a rotating basis to perform utilization reviews and other UM activities, as needed, to… more
- Fresenius Medical Center (Lowell, MA)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Medford, MA)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... by working with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are followed. + Responsible… more
- Fresenius Medical Center (Lowell, 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
- 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 ... to the care team with primary responsibilities for disease management , care coordination, and advice/triage needs for the care...+ Education: Associate degree in nursing + Current Massachusetts Registered Nurse ( RN ) license degree… more
- Baystate Health (Springfield, MA)
- …(BMC), a Magnet Hospital for Nursing Excellence is looking for a medical inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... Support - American Heart AssociationAmerican Heart AssociationAmerican Heart Association, Registered Nurse - State of MassachusettsState of MassachusettsState… more
- Baystate Health (Springfield, MA)
- …a Magnet Hospital for Nursing Excellence is looking for a medical telemetry inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health, ... Support - American Heart AssociationAmerican Heart AssociationAmerican Heart Association, Registered Nurse - State of MassachusettsState of MassachusettsState… more
- Lawrence General Hospital (Methuen, MA)
- …experience in an acute care setting with discharge planning, continuing care, care management , and utilization review preferred. + Strong verbal and written ... 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… more
