- Beth Israel Lahey Health (Plymouth, MA)
- …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… more
- Beth Israel Lahey Health (Burlington, MA)
- …people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for ... Clinic inpatient admissions. Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case… more
- Sharecare (Boston, MA)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Beth Israel Lahey Health (Cambridge, MA)
- …difference in people's lives.** Join our team as a key Emergency Department nurse in our renovated and expanded department, caring for approximately 34,000 patients ... to older adults. **Job Description:** **Primary Responsibilities** 1. The emergency nurse initiates accurate and ongoing assessment of physical, psychological and… more
- Fresenius Medical Center (Springfield, MA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- State of Massachusetts (Boston, MA)
- …social workers, physicians, and professional staff, while also participating in Census and Utilization Review Committees under the guidance of the Director of ... ensuring access for special populations./ * /Prepare reports for utilization review and census meetings./ * /Assist...years of full-time, or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic… more
- Evolent (Boston, MA)
- …are applied appropriately. **Qualifications:** + Current, unrestricted state licensure as a Registered Nurse + Associate or Bachelors in Nursing (Must be ... , you will be a key member of the utilization management team. We can offer you a meaningful...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not...a Registered Nurse ) + Experience as an RN… more
- Baystate Health (Springfield, MA)
- …- American Heart AssociationAmerican Heart Association, Driver License - OtherOther, Registered Nurse - State of MassachusettsState of Massachusetts **Equal ... **RN, ACO Nurse Care Manager, Community Health Center** The **ACO...room, or from a skilled nursing facility. Responsible to review the discharge summaries, follow up on testing that… more
- Humana (Boston, MA)
- …currently living in Puerto Rico. + A current, valid and unrestricted license as a Registered Nurse (RN) + Minimum Associate's degree in Nursing + 2 years case ... community and help us put health first** The **Telephonic Nurse Case Manager** will be a member of the...or Master's degree in Nursing + Prior/current experience in Utilization Management/ Utilization Review with MCG… more
- Lincoln Financial (Boston, MA)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more