NewTravel Nurse RN - Utilization Review - $2,989 to $3,084 per week in Everett, MA TravelNurseSourceTravel Nurse RN - Utilization Review - $2,989 to $3,084 per week in Everett, MAEverett, MA$2,989–$3,084As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
NewDirector Registered Nurse (RN) - Case Management - $119K-183K per year Tenet MassachusettsDirector Registered Nurse (RN) - Case Management - $119K-183K per yearWorcester, MA$119,000–$183,000 / yearThe individual in this position has overall responsibility for hospital utilization management, transition management, and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services. Healthgrades awarded Saint Vincent Hospital #1 in Cardiology in the state and one of America’s 100 Best Hospitals for Coronary Intervention in 2023 and 2024, which puts Saint Vincent Hospital in the top 5% of hospitals nationwide for coronary intervention.
NewTravel Nurse RN - Case Management - $4,001 per week Amergis Healthcare Staffing, Inc.Travel Nurse RN - Case Management - $4,001 per weekHyannis, MAThis position will oversee functions of the Clinical Resource Department as they pertain to discharge planning, utilization management, and care coordination/high risk patient process while maintaining the integrity of daily operations. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school.
NewAssistant Director of Nursing, RN Linden Ponds by Erickson Senior LivingAssistant Director of Nursing, RNWeymouth, MA$120,000–$150,000 / yearLocation: Linden Ponds by Erickson Senior Living Join our team as the Assistant Director of Nursing is responsible for clinical leadership and outcomes within our Skilled, Assisted Living, and Memory Care neighborhoods. See Erickson Senior Living Privacy Policy at https://www.ericksonseniorliving.com/privacy-policy and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
Registered Nurse (RN), Float Critical Care / ICU Yale New Haven HealthRegistered Nurse (RN), Float Critical Care / ICULowell, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Registered Nurse Float – Critical Care Yale New Haven HealthRegistered Nurse Float – Critical CareWorcester, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Registered Nurse Critical Care (ICU) – Float Pool Yale New Haven HealthRegistered Nurse Critical Care (ICU) – Float PoolCambridge, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Registered Nurse – ICU Float Unit Yale New Haven HealthRegistered Nurse – ICU Float UnitWorcester, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
RN Float Pool – Critical Care Yale New Haven HealthRN Float Pool – Critical CareBoston, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Registered Nurse - ICU Yale New Haven HealthRegistered Nurse - ICUWorcester, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Behavioral Health RN Yale New Haven HealthBehavioral Health RNBoston, MAUnder the supervision of the Nurse Manager or Clinical Coordinator, the Registered Nurse (RN) provides comprehensive, patient-centered care across a diverse behavioral health population, we have open roles, and various shifts open in Adolescent Psychiatry, General Adult, Geriatric Psychiatry, Mood Disorders, and Transitional Youth . This role includes supervising non-RN staff, coordinating patient care activities, and serving in a charge nurse capacity when assigned, including delegation and oversight of unit operations.
RN - Acute Care Medicine Yale New Haven HealthRN - Acute Care MedicineBoston, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
RN - Psychiatric Services / Psych Unit Yale New Haven HealthRN - Psychiatric Services / Psych UnitBoston, MAUnder the supervision of the Nurse Manager or Clinical Coordinator, the Registered Nurse (RN) provides comprehensive, patient-centered care across a diverse behavioral health population, we have open roles, and various shifts open in Adolescent Psychiatry, General Adult, Geriatric Psychiatry, Mood Disorders, and Transitional Youth . This role includes supervising non-RN staff, coordinating patient care activities, and serving in a charge nurse capacity when assigned, including delegation and oversight of unit operations.
RN - Behavioral Medicine / Behavioral Services Yale New Haven HealthRN - Behavioral Medicine / Behavioral ServicesBoston, MAUnder the supervision of the Nurse Manager or Clinical Coordinator, the Registered Nurse (RN) provides comprehensive, patient-centered care across a diverse behavioral health population, we have open roles, and various shifts open in Adolescent Psychiatry, General Adult, Geriatric Psychiatry, Mood Disorders, and Transitional Youth . This role includes supervising non-RN staff, coordinating patient care activities, and serving in a charge nurse capacity when assigned, including delegation and oversight of unit operations.
RN - General Medicine Yale New Haven HealthRN - General MedicineBoston, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Mental Health RN Yale New Haven HealthMental Health RNBoston, MAUnder the supervision of the Nurse Manager or Clinical Coordinator, the Registered Nurse (RN) provides comprehensive, patient-centered care across a diverse behavioral health population, we have open roles, and various shifts open in Adolescent Psychiatry, General Adult, Geriatric Psychiatry, Mood Disorders, and Transitional Youth . This role includes supervising non-RN staff, coordinating patient care activities, and serving in a charge nurse capacity when assigned, including delegation and oversight of unit operations.
RN General Medicine - Immediate Hiring Yale New Haven HealthRN General Medicine - Immediate HiringBoston, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
NewRegistered Nurse (RN) - Clinical Coordinator, ED - Emergency Department - $40-75 per hour Tenet MassachusettsRegistered Nurse (RN) - Clinical Coordinator, ED - Emergency Department - $40-75 per hourSouthborough, MA$40–$75 / hourHealthgrades awarded Saint Vincent Hospital #1 in Cardiology in the state and one of America’s 100 Best Hospitals for Coronary Intervention in 2023 and 2024, which puts Saint Vincent Hospital in the top 5% of hospitals nationwide for coronary intervention. An experienced Registered Nurse, who in addition to providing direct patient care, is accountable for facilitating an interdisciplinary approach to patient care, patient flow, staffing, resource utilization and problem solving.
Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical CareDialysis Clinical Manager Registered Nurse - RNAttleboro, MA$79,000–$133,000 / yearAs the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support.
Registered Nurse (RN) - ICU Yale New Haven HealthRegistered Nurse (RN) - ICUCambridge, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Registered Nurse (RN) – ICU Float Yale New Haven HealthRegistered Nurse (RN) – ICU FloatCambridge, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Registered Nurse (RN) – Critical Care Float Pool Yale New Haven HealthRegistered Nurse (RN) – Critical Care Float PoolWorcester, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Medical-Surgical Registered Nurse (Med-Surg RN) Yale New Haven HealthMedical-Surgical Registered Nurse (Med-Surg RN)Cambridge, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Critical Care Float Nurse / Float RN (ICU) Yale New Haven HealthCritical Care Float Nurse / Float RN (ICU)South Boston, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
RN - Medicine/Telemetry (Med/Tele RN) Yale New Haven HealthRN - Medicine/Telemetry (Med/Tele RN)Boston, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
RN - Medical Unit (Med Unit RN) Yale New Haven HealthRN - Medical Unit (Med Unit RN)Boston, MADevelops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Psychiatric Registered Nurse (Psych RN) Yale New Haven HealthPsychiatric Registered Nurse (Psych RN)Boston, MAUnder the supervision of the Nurse Manager or Clinical Coordinator, the Registered Nurse (RN) provides comprehensive, patient-centered care across a diverse behavioral health population, we have open roles, and various shifts open in Adolescent Psychiatry, General Adult, Geriatric Psychiatry, Mood Disorders, and Transitional Youth . This role includes supervising non-RN staff, coordinating patient care activities, and serving in a charge nurse capacity when assigned, including delegation and oversight of unit operations.
NewTravel Nurse RN - Psych in Worcester, MA TravelNurseSourceTravel Nurse RN - Psych in Worcester, MAWorcester, MAThe Nursing Director assumes 24/7 accountability for assigned departments and plays a key role in ensuring high-quality patient care, staff competency, clinical excellence, and effective resource management. This role supports executive nursing leadership and is responsible for assisting with the planning, coordination, implementation, and evaluation of nursing practice across multiple patient care units.
Therapist, Behavioral Health, Outpatient Valley Springs Behavioral Health HospitalTherapist, Behavioral Health, OutpatientHolyoke, MA$62,816–$84,801Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. Programs include inpatient mental health and co-occurring treatment, Partial Hospitalization Programs (PHP), and Intensive Outpatient Programs (IOP).
RN Manager, Case Management / Utilization Management Blue Cross and Blue Shield of Massachusetts IncRN Manager, Case Management / Utilization ManagementHingham, MA$104,580–$127,820 / yearAn employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page.
Clinical Guide Part A: Utilization Management Nurse Devoted Health ServicesClinical Guide Part A: Utilization Management NurseMassachusettsRemoteThe actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.
Utilization Management Nurse Consultant - Eastern Time Zone CVS Health CorpUtilization Management Nurse Consultant - Eastern Time ZoneMARemote$32.01–$68.55 / hourThe UM Nurse Consultant job duties include (not all encompassing): Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the complex needs of the member. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
Clinical Guide Part A: Utilization Management Nurse Devoted Health IncClinical Guide Part A: Utilization Management NurseWaltham, MARemote$85,000–$95,000 / yearThe actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going - all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.
NewUtilization Management Nurse Consultant CVS Health CorpUtilization Management Nurse ConsultantMA$26.01–$62.32 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Sr Utilization Management Nurse RN - Remote UnitedHealth Group IncSr Utilization Management Nurse RN - RemoteBoston, MARemote$72,800–$130,000 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring the accuracy of medical record coding, supporting proper payment to nursing facilities, and promoting quality patient care.
Nurse Manager - Utilization Management (Full Time) Lahey Hospital and Medical CenterNurse Manager - Utilization Management (Full Time)Burlington, MA$165,000–$215,000 / yearAssigns and reviews staff schedules and workflows and works closely with other administrative and clinical areas under the direction of the Executive Director and the VP of Revenue Cycle/Chief Revenue Officer as part of an integrated Revenue Cycle model. Manages the Utilization Management (UM) team, maintaining effective and efficient processes for determining appropriate patient admission status based on regulatory and reimbursement requirements of various commercial and government payers.
RN - Manager, Medicare and DSNP Utilization Management IMCS Group IncRN - Manager, Medicare and DSNP Utilization ManagementSomerville, MACompany Description: IMCS Group is one of the fastest growing MWBE (Minority Woman Owned Enterprise) staffing firms in the U.S. We focus on bringing a Diversity Recruitment approach to Fortune 500 companies within North America and EMEA region contingent labor programs. IMCS Group is committed to maintaining an inclusive workforce, where employees are hired, retained, compensated, and promoted based on their contributions to our Company.
Utilization Review Nurse - Per-Diem Lawrence General HospitalUtilization Review Nurse - Per-DiemLawrence, MA$37.50–$76.34 / hourUtilizing Interqual Level of Care Criteria, ensures appropriate service assignment (inpatient vs observation) and collaborates with attending MD to reduce possibility of reimbursement denials Provides clinical information necessary for authorization to 3rdparties within one business day of request Communicates excess day and/or denial information to the team; resolves delays by negotiating with the team, ancillary services, 3rdparties Rounds with the care team and collaborates with the team to identify patient/families with complex discharge needs. Ensures patients are discharged appropriately to alternative sites in a timely manner Qualifications: BSN required; Masters degree preferred Current Massachusetts Nursing license Minimum 5 years clinical nursing experience 5 years case management experience in an acute care setting with discharge planning, continuing care, care management, and utilization review preferred.
Utilization Review Nurse - Per-Diem Merrimack HealthUtilization Review Nurse - Per-DiemLawrence, MA$37.50–$76.34 / hourThe URN is responsible for working with the Clinical Care Coordinator and Complex Care Manager to facilitate timely discharge, assure medical documentation accurately reflects the patient’s severity of illness; and ensures compliance with the conditions of participation as they relate to Utilization Review and Discharge planning and payer regulations. Merrimack Health is a private, non-profit community hospital providing the Merrimack Valley & southern New Hampshire regions with patient-centered, compassionate, and quality health care for the whole family.
Director, Utilization Management Operations Devoted Health ServicesDirector, Utilization Management OperationsMassachusettsRemoteThat’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Utilization Review Registered Nurse Supplemental Health CareUtilization Review Registered NurseBoston, MAFull timeThis Magnet-recognized, teaching hospital is nationally respected for its innovation, advanced patient care, and commitment to nursing excellence, offering you the chance to grow your skills in a truly dynamic environment. With over 40 years of experience connecting healthcare professionals to opportunities that fuel their careers, Supplemental Health Care is here to help you succeed every step of the way.
Director, Utilization Management Operations Devoted Health IncDirector, Utilization Management OperationsWaltham, MARemote$182,000–$248,000 / yearThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Utilization Review Registered Nurse Prairie Lakes Healthcare SystemUtilization Review Registered NurseWatertown, Massachusetts$28.09–$44.81 / hourRefers all cases where necessity for admission is questionable or potential for denial is identified to the attending physician or his/her designee for appropriate action after notifying the Discharge Planning/Social Services manager. This full-time (0.9 status or 36 hours per week) position ensures the medical necessity for hospital services, admissions and continued stay are met per specific Medicare and commercial payor guidelines.
RN Clinical Coordinator, Case Management, 32-Hours, Days, No Weekends or Holidays Athol HospitalRN Clinical Coordinator, Case Management, 32-Hours, Days, No Weekends or HolidaysAthol, Massachusetts$38–$57.48 / hourFull timeWorks collaboratively with a multidisciplinary team to determine each patient's needs concurrently including post-acute care when needed; addresses LOS issues, appropriate leveling of patient status; addresses potential needs, resources, referrals for other disciplines etc. Responsible for completing nursing sections of the SNF Level of Care forms for Mass Health patients in need of care, SNF placement, timely and efficiently and other forms assisting in transition of care as identified and collaborates with the social worker.
Utilization Review Clinician TaraVistaUtilization Review ClinicianDevens, MA$80,000–$90,000 / yearYou are responsible for pre-certification, concurrent and discharge reviews, appeals and denials, and the compliance of contracted quality measures identified by managed care organizations. You will serve as liaison between the hospital and outside payor sources in accordance with the mission and core principals of MiraVista Behavioral Health Center.
RN Care Coordinator, Case Management, 8-Hours, Mornings, Weekends, 4 hour shifts on Saturdays and Sundays Heywood HospitalRN Care Coordinator, Case Management, 8-Hours, Mornings, Weekends, 4 hour shifts on Saturdays and SundaysGardner, Massachusetts$38–$78.93 / hourPart timeQuality & Statistical Data: Reviews medical record for abnormal findings,complications, delays and deviations from expected clinical outcomes reports such to Provider and/or Director to maintain an efficient, cost effective episode of care for each patient and documents intervention provided. Organizational Expectations Behavioral Attributes: The following behavioral attributes are required: achievement motivation, flexibility, concern for order, initiative, self-confidence, self control, customer service orientation, interpersonal effectiveness, teamwork and information seeking.