- Evolent (Boston, MA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- HCA Healthcare (Manchester, NH)
- …Center we support our colleagues in their positions. Join our Team as a(an) RN Clinical Nurse Leader Cardiovascular Tele and access programs to assist with every ... certifications and job skills. Apply today for our RN Clinical Nurse Leader Cardiovascular Tele opening and...registration in the State of NH as a Registered Nurse . Catholic Medical Center (CMC) (https://catholicmc.com/) is… more
- 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
- Elevance Health (Woburn, MA)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for...reviews that are routine having limited or no previous medical review experience requiring guidance by more… more
- Fresenius Medical Center (Peabody, MA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- Summary This Registered Nurse - Clinical Nurse Coordinator position is located in the Office of Community Care at the Brady Sullivan Tower Building in ... thinking skills. Possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical … 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
- Elevance Health (Woburn, MA)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role enables associates to work virtually ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Clinical Fraud Investigator II** is responsible… more
- BAYADA Home Health Care (Wilmington, MA)
- …DCO to ensure cohesive and consistent management of all field staff. + Review all clinical documentation to ensure consistent, accurate, high-quality services. + ... BAYADA Home Health Care is seeking a Registered Nurse (RN) to fill the position of **Home...holidays, vacation and sick leave. + Vision, dental and medical health plans. + Employer paid life insurance, 401k… more
- HCA Healthcare (Derry, NH)
- …for some benefits may vary by location._** **Job Summary and Qualifications** The HCA Nurse Residency Program at Parkland Medical Center provides you with the ... join an organization that invests in you?_ **At** **Parkland Medical Center** **, you come first!** HCA Healthcare is...growth and development of our future nurses! The **HCA Nurse Residency Program** is a year-long program designed to… more
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