- Humana (Boston, MA)
- …where your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager , you will spearhead audit and validation ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
- Beth Israel Lahey Health (Newburyport, MA)
- …information from a variety of sources (eg Auditors, CMS, BCBS, Permedion, DPH, Nurse Audit , HCHP, DPH, Disability, Workman's Comp, EHR, attorneys, patients, ... direction of the Director of Health Information Management, the Health Information Management Audit Specialist handles various audit requests for the release of… more
- Elevance Health (Woburn, MA)
- **Telephonic Nurse Case Manager Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager Senior** is responsible for care management within… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Inpatient Case Manager performance is evaluated using the Inpatient Case Manager Guidelines and audit tool. Reports to Inpatient Case Management Supervisor. ... teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH… more
- Sunrise Senior Living (Norwood, MA)
- …Sunrise of Norwood **Job ID** 2025-234088 **JOB OVERVIEW** The LPN Medication Care Manager is responsible for providing the highest degree of quality care and ... medication updates from Resident Care Director (RCD) or Wellness Nurse . + Administer, assist with, and observe medications and...supervisor. + Count all narcotics with another Medication Care Manager (MCM) or Lead Care Manager (LCM)… more
- Commonwealth Care Alliance (Springfield, MA)
- …and ensuring timely submission to MassHealth. The department includes registered nurse assessors and reviewers. The assessors are organized into teams and ... geographically dispersed across the commonwealth The Assessment nurse conducts timely, high-quality, accurate in-person assessments. These individuals leverage the… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by leading the ... reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts,...medical record review and periodic medical record review for audit purposes as well as medical record review for… 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 ... - Taylor Building Position Summary: The 340B Program, Licensing and Credentialing Manager is charged with oversight of NeighborHealth's 340B pharmacy program. This… more
- East Boston Neighborhood Health Center (Revere, 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 ... All Locations: 300 Ocean Avenue - Revere Position Summary: The Social Work Manager provides individual and group clinical supervision to social workers across all… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the daily ... operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and authorization creation for… more