5 utilization review nurse rn jobs found

Hours: 40 hours weekly, Monday-Friday 830am-5pm Location: 178 Savin Street Suite 100 & 200A, Malden MA 02148 Job Profile Summary This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following Nursing Leadership duties: Controls, directs, and participates in the activities of the organization through a hierarchy of managers and supervisors. Responsibilities also include long-term strategic planning, determining the policies of the organization, and allocating its resources and making decisions regarding organization growth and diversification to accomplish entity's vision. A management role that supervises employees focusing on tactical, operational activities within a specified area, with the majority of time spent overseeing area of responsibility, planning, prioritizing and/or directing the responsibilities of employees. Goal achievement is...

Hours: 40 hours weekly, Monday-Friday 830am-5pm Location: 178 Savin Street Suite 100 & 200A, Malden MA 02148 Job Profile Summary This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following Nursing Leadership duties: Controls, directs, and participates in the activities of the organization through a hierarchy of managers and supervisors. Responsibilities also include long-term strategic planning, determining the policies of the organization, and allocating its resources and making decisions regarding organization growth and diversification to accomplish entity's vision. A management role that supervises employees focusing on tactical, operational activities within a specified area, with the majority of time spent overseeing area of responsibility, planning, prioritizing and/or directing the responsibilities of employees. Goal achievement is...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. 40 hours per week; 9:00am-5:30pm or 9:30am-6:00pm; Rotate Every Third Weekend & Holidays Job Description: Job Summary: The RN Case Manager (CM) facilitates the coordination of care for those patients admitted to medical, surgical services, ICU, and as needed for outpatient areas including but not limited to the Emergency Department, PACU and Preadmission testing. The case manager consults and collaborates in activities related to the establishment of appropriate levels of care. He/She reviews patient's medical records and participates in direct and indirect communication with care givers to ensure continued appropriate level of acre, including the level of care of elective surgical cases. The case manager provides ongoing education to the physicians and nurses about levels of care. The RN Case manager, performs, consults, and collaborates in...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Reporting to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in investigating patient safety incidents, risk management, reviewing publicly reported quality data by reviewing charts in the EMR, reviewing outliers, compiling reports and serving as the liaison with clinical stakeholder and clinical committees in sharing the outcomes of safety incidents and data. In addition to the goal of optimizing performance on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of safety by specifically focusing on high reliability processes to reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret data, and implement quality improvement initiatives to deliver excellence in clinical care....

Reporting to the Director of Patient Financial Services, the Revenue Protection Specialist is responsible for managing and responding to external audits from government and commercial insurance companies as well as interpreting evolving payer policies to safeguard the Institute’s revenue. This role requires a clinical background to ensure clinical accuracy and compliance in audit responses and policy interpretations. The Revenue Protection Specialist will utilize their clinical expertise and knowledge of billing practices to address audit findings, interpret payer policies, prepare detailed responses and implement corrective actions to enhance compliance and revenue integrity. This position serves as a key liaison between the Institute and external auditors, ensuring timely and accurate communication. Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our...