- Cognizant (Boston, MA)
- …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... **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
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to help us transform healthcare? Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating care for ... benefit to provide the best quality care. The TeamThe RN Utilization Management Reviewer is...Mobile, and Resident personas. This position can be fully remote with an in-office requirement to work 1-3x/month at… 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
- CenterWell (Pittsfield, MA)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... **Branch Location** : Pittsfield, MA **This is not a remote or work-from-home position. This position requires you to...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Point32Health (Canton, MA)
- …with the interdisciplinary care team, to improve member outcomes (ie, Utilization Management , Medical Director, pharmacy, community health workers, dementia ... Qualifications - what you need to perform the job Certification and Licensure + Registered Nurse with current unrestricted license in state of residence + May… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …health care settings (Inpatient, outpatient, or differing levels of care). + Utilization Management experience, preferred. + Active licensure in Massachusetts is ... Bring your true colors to blue. The Role The RN Case Manager is responsible for facilitating care for...to facilitate care based on the principles of care management . Facilitation is focused on assessing needs, identifying health… more
- Parexel (Boston, MA)
- …Title:** Data Management Lead (Medical Affairs) - Oncology **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** ... solutions. We are seeking a dynamic and experienced Data Management Lead to join our team. If you have...practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable… 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, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more
- Commonwealth Care Alliance (Boston, MA)
- …member experience. * Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... does not have direct reports. Essential Duties & Responsibilities: Provider Relationship Management * Serve as the primary relationship manager and point of contact… more
- J&J Family of Companies (Boston, MA)
- …or research experience) Must be familiar with Microsoft Word, Excel, PowerPoint, and utilization of computers and remote technologies. Ability to travel up to ... and health care providers (MD, DO, PhD, PA, NP, RN , Pharm.D., bio coordinators) and developing and managing a...Must be familiar with Microsoft Word, Excel, PowerPoint, and utilization of computers and remote technologies. Johnson… more