• Utilization Management Administration…

    Humana (Boston, MA)
    …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied activities and… more
    Humana (08/23/25)
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  • ED RN Case Manager - UR & Discharge Planning

    Beth Israel Lahey Health (Plymouth, MA)
    …+ State of MA Registered Nurse (RN) + 3-5 years acute care nursing + Two years of recent utilization management and discharge planning experience ... documentation of patient choice of service providers Identifies potential quality & risk management issues based on...healthcare related field + Three years of recent utilization management and discharge planning experience + ED nursing more
    Beth Israel Lahey Health (08/10/25)
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  • Insurance Strategy Consultant

    Humana (Boston, MA)
    …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest US hospital corporation in… more
    Humana (08/29/25)
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  • Senior Accreditation Utilization Management

    Humana (Boston, MA)
    …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time management more
    Humana (09/03/25)
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  • Care Coordinator / Navigator - Cape Cod

    Fallon Health (Barnstable, MA)
    …is an integral part on an interdisciplinary team focused on care coordination, care management and improving access to and quality of care for Fallon members. ... Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top… more
    Fallon Health (08/08/25)
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  • MDS FT RN Experience in LTC is required

    Bear Mountain Health Care (East Longmeadow, MA)
    …Work Experience and Educational Requirements: + Must possess, as a minimum - RN Nursing Degree from an accredited college or university and a minimum of 1-year MDS ... nurses to join our team and help provide professional nursing care for our family of residents. About our...loved ones. General Description: This role requires a registered nurse (RN) who conducts federally mandated assessments of the… more
    Bear Mountain Health Care (07/01/25)
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  • RN Clinical Manager

    Aveanna Healthcare (Worcester, MA)
    …(preferred) + Deep understanding of state/federal compliance and private duty nursing operations + Strong communication, time management , and problem-solving ... Healthcare - Worcester, MA Are you a skilled Registered Nurse with a passion for leadership and a heart...with your leadership abilities - and truly shape the quality of care we deliver. What You'll Be Doing… more
    Aveanna Healthcare (07/30/25)
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  • Clinical Documentation Specialist

    Brockton Hospital (Brockton, MA)
    The CDS works collaboratively with Coding, Medicine, Nursing , Case Management , the Quality Department and ancillary staff to perform concurrent analytical ... profiling, and reimbursement. + Knowledge of pathophysiology and disease process; Medicare Part A and B knowledge of regulatory environment. + Understanding… more
    Brockton Hospital (06/26/25)
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  • Home Health Aide (HHA)

    Aveanna Healthcare (Framingham, MA)
    …offers both short-term and long-term care services, catering to individuals under the Medicare and Medicaid programs, as well as those with Private Insurance and ... individuals with chronic conditions, behavioral health challenges, monitoring requirements, skilled nursing , and therapeutic needs. Our patients span all age groups,… more
    Aveanna Healthcare (09/03/25)
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  • Growth Strategy Consultant

    Humana (Boston, MA)
    …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest...The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana's largest, which comprises over… more
    Humana (08/27/25)
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