• Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
    DirectEmployers Association (10/02/25)
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  • Case Manager , Registered

    CVS Health (Boston, MA)
    …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
    CVS Health (12/16/25)
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  • Registered Nurse Case Manager

    Beth Israel Lahey Health (Boston, MA)
    …taking a job, you're making a difference in people's lives.** The RN Case Manager working in the Triad Model of Care Transitions partners with the interdisciplinary ... patient. Together with the medical provider, the RN Case Manager collaborates with all members of the care team,...of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a… more
    Beth Israel Lahey Health (11/21/25)
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  • NEBH Operating Room Registered Nurse

    Beth Israel Lahey Health (Boston, MA)
    …Demonstrates professional commitment and is responsible for ensuring patient safety. **Resource Utilization ** + The registered nurse considers factors ... just taking a job, you're making a difference in people's lives.** Operating Room (OR) Registered Nurse - New England Baptist Hospital Full Time Operating room … more
    Beth Israel Lahey Health (12/04/25)
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  • Dialysis Clinical Manager Registered

    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 operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
    Fresenius Medical Center (12/06/25)
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  • Quality & Patient Safety Specialist…

    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,...If you're unable to resolve a situation, find a manager who can. **9. Protect confidentiality and privacy:** It's… more
    Beth Israel Lahey Health (10/30/25)
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  • Nurse Case Manager - Per Diem

    Beth Israel Lahey Health (Cambridge, MA)
    …Qualifications:** 1. Bachelor's degree preferred. 2. Current Massachusetts state license as a Registered Nurse (RN). 3. Two years of recent acute hospital ... care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning… more
    Beth Israel Lahey Health (10/30/25)
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  • Complex Case Manager

    Beth Israel Lahey Health (Burlington, MA)
    …to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure, ... Standards of Practice and Code of Ethics, the Case Manager performs duties relative to utilization and...Must hold current Commonwealth of Massachusetts license as a Registered Nurse , and Basic Life Support (BLS)… more
    Beth Israel Lahey Health (11/21/25)
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  • RN Case Manager - Inpatient Case Management…

    Cambridge Health Alliance (Cambridge, MA)
    …**Work Days** : Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category** : Registered Nurse **Department** : Inpatient Case Management CH **Job Type** ... RN Case Manager - Inpatient Case Management CH **Requisition Number:**...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
    Cambridge Health Alliance (12/13/25)
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  • RN Case Manager - Inpatient Case Management…

    Cambridge Health Alliance (Somerville, MA)
    …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH **Job ... RN Case Manager - Inpatient Case Management SH **Requisition Number:**...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
    Cambridge Health Alliance (09/25/25)
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