- Commonwealth Care Alliance (Boston, MA)
- …Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but ... **Required Knowledge, Skills & Abilities (must have):** + Experience with prior authorization and retrospective reviews + Proficiency reviewing clinical/medical… more
- North Shore Community Health (Salem, MA)
- …opening for a Registered Nurse . Under the general direction of the Clinical Nurse Manager , the Registered Nurse will provide direct and indirect ... Registered Nurse Salem, MA (http://maps.google.com/maps?q=47+Congress+Street+Salem+MA+USA+01970) Description...when needed within the scope of nursing practice, including prior authorization forms . Provides health education… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …coverage denials cannot be overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + ... environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and… 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. + One ... in nursing required** **License/Certifications** + Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience** + A minimum of three… more
- Beth Israel Lahey Health (Plymouth, MA)
- …the job that may reasonably be required._ **Education/Experience Required:** _Required_ + State of MA Registered Nurse ( RN ) + 3-5 years acute care nursing + ... summer and one winter holiday. **Job Description:** The Emergency Department Case Manager is responsible and accountable for patient trajectory by assisting the… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …Pediatrics All Locations: 10 Gove Street - Taylor Building Position Summary: A registered nurse holds ultimate responsibility for direct and indirect nursing ... the department's immediate needs and long-term goals. In addition, the registered nurse demonstrates initiative, critical thinking, problem solving, leadership… more
- Beth Israel Lahey Health (Cambridge, MA)
- …a job, you're making a difference in people's lives.** Reporting to the unit's Nurse Manager , the Wound Care Specialist- RN works collaboratively with members ... well-being and as required for license renewal. **Minimum Qualifications:** + License Registered Nurse in the Commonwealth of Massachusetts required. +… more
- East Boston Neighborhood Health Center (Winthrop, MA)
- …26 Sturgis Street - PACE Winthrop Position Summary: Job Description Summary A Registered Nurse holds ultimate responsibility for direct and indirect nursing ... well-being of our patients and communities. Whether you're a nurse or physician providing direct care, a manager...Manages the refills of all patient medications with appropriate authorization by the provider. + Provide and coordinate health… more
- Bear Mountain Health Care (Lowell, MA)
- …transfer and discharge of residents and provides the information to the Nurse Manager . Completes clinical admission paperwork. Assists with clinical discharge ... Bear Mountain Healthcare has immediate openings for Registered Nurses looking to work in our Long...practice + Responsible for completing medication interchange and insurance prior to authorization as assigned + Ordering… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …to the health and well-being of our patients and communities. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or ... a $2500 Sign on bonus! The Home Care Primary Nurse is responsible for the general oversight, assessment, planning,...and the orders of the participant's medical providers. The RN is responsible for the delivery and documentation of… more
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