- Evolent (Providence, RI)
- …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
- Humana (Providence, RI)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Fresenius Medical Center (Pawtucket, RI)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- University Medicine (Providence, RI)
- SUMMARY: Reporting to the Manager of Case Management, the nurse case manager is responsible for providing comprehensive screenings, assessment, care coordination ... the intent of encouraging self-management for patients with chronic conditions. The Nurse Case manager is integrated in the office-based healthcare team and thereby… more
- Fallon Health (Foxborough, MA)
- …Information (CORI) results and reliable transportation **Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members ... the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge,… more
- Brown University (Providence, RI)
- …and conduct support activities related to these duties. The Research NP will review medical histories with research participants, perform a physical examination ... Job Description: Position Purpose: The Research Nurse Practitioner (NP) will provide medical ...research participation, and administer questionnaires. The Research NP will review health updates and adverse event reports from study… more
- CVS Health (Woonsocket, RI)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- CVS Health (Providence, RI)
- …criteria to evaluate outpatient and inpatient services requiring precertification and concurrent review . + Conduct clinical reviews via phone and electronic ... Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care… more
- BioLife Plasma Services (Attleboro, MA)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …and our team is expanding across sites to support this growth. We're hiring a Nurse (RN or LPN) for our Primary Care Clinic in Milford, MA who collaborates with ... the healthcare team to deliver quality primary medical care for patients of all ages, races, and...support to patients' families, and working collaboratively with the clinical practice team. They also participate in coordinating care,… more