- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible… more
- Commonwealth Care Alliance (Boston, MA)
- … Nurse and Specialist staff responsible for conducting centralized clinical review and authorization creation for centrally authorized services. This ... Utilization Management reports to the Director of Utilization Management - Oversees clinical decision review for services requiring prior authorization in a… more
- Commonwealth Care Alliance (Springfield, MA)
- …This panel of patients incorporates the care of individuals with significant medical , behavioral, and social complexities that require intensive care management and ... care delivery and care coordination for the most complex medical and behavioral health patients. The SBHC functions within...plan of care. The SBHC uses evidence-based care approaches, clinical skills, education, and training to influence the … more
- Commonwealth Care Alliance (Boston, MA)
- …Required Licensing (must have): - None Desired Licensing (nice to have): - Medical Assistant or Licensed Practical Nurse - Coding Certification Required ... This patients we serve are most often are individuals with significant medical , behavioral, and social complexities that require intensive care delivery.? Within the… more
- Commonwealth Care Alliance (Springfield, MA)
- …panel of CCA's patients incorporates the care of individuals with significant medical , behavioral, and social complexities that require intensive care management and ... care delivery and care coordination for the most complex medical and behavioral health patients. The CHW participates in...his/her needs. This position reports to the CIC CHW Clinical Manager **Supervision Exercised:** + No, this position does… more
- Monte Nido (Dedham, MA)
- …to electrolyte imbalances, malnutrition, and refeeding syndrome. + Conduct routine medical assessments and follow-ups, including laboratory review and medication ... Dedham, MA, location. This physician will play a crucial role in the medical management of patients with eating disorders and co-occurring medical conditions.… more
- Evolent (Boston, MA)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Children's Hospital Boston (Boston, MA)
- …of experience in hospital surgery, surgical clinics, surgical clinical research, or medical records + Clinical chart review and abstraction experience ... 82669BRJob Posting Title:Surgical Clinical Reviewer (20 hours/week)Department:Patient Services-Patient Care...to clinical teams. Key Responsibilities + Perform clinical review of surgical cases to support… more
- Fresenius Medical Center (Fairhaven, MA)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Dana-Farber Cancer Institute (Boston, MA)
- …for a non-oncology area, eg infection control) and the process of conducting medical clinical research. In addition, the CRN utilizes evidence-based nursing ... The Research Nurse in collaboration with the physician, is responsible...physician, is responsible for the implementation and evaluation of clinical research in their specific program/area. The CRN has… more
