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Utilization review nurse jobs in Massachusetts

- 830 jobs
  • Utility Management Nurses (Insurance Coding & Revenue Management)

    Mercor

    Utilization review nurse job in Boston, MA

    We're seeking experienced **Utility Management Nurses** to support a client's healthcare product development by leveraging expertise in **insurance coding and hospital revenue management workflows**. This role involves collaborating with hospital systems to align medical documentation with insurance policies, ensuring accurate coding and optimal reimbursement outcomes. ### **Key Responsibilities** - **Insurance Coding & Revenue Cycle Alignment:** Review, audit, and optimize insurance coding practices across hospital systems to ensure compliance and maximize reimbursement accuracy. - **Workflow Analysis:** Evaluate existing revenue management workflows and recommend improvements tailored to client's AI-driven documentation tools. - **Clinical Data Interpretation:** Translate complex clinical notes into standardized coding formats (ICD-10, CPT, HCPCS) aligned with payer policies. - **Policy Matching:** Assess coding accuracy against insurance guidelines and payer documentation requirements. - **Product Development Collaboration:** Work closely with client's engineering and product teams to refine AI models that automate or assist with medical coding and documentation. - **Compliance & Quality Assurance:** Ensure alignment with HIPAA, CMS, and payer-specific coding regulations. ### **Required Qualifications** - **Licensure:** Registered Nurse (RN) or equivalent clinical background. - **Experience:** Minimum 3-5 years in **medical coding**, **clinical documentation improvement (CDI)**, or **revenue cycle management**. - **Certifications:** CPC, CCS, or CRC certification preferred. - **Domain Expertise:** Familiarity with **hospital billing systems**, **payer policy interpretation**, and **coding audit procedures**. - **Analytical Skills:** Strong understanding of clinical documentation standards and payer logic. - **Tech Savvy:** Comfortable working with EHR systems (Epic, Cerner, Meditech) and documentation review software. ### **Preferred Qualifications** - Experience working within **hospital revenue integrity teams** or **insurance utilization management**. - Exposure to **AI-powered healthcare documentation tools** or **automated coding systems**. - Ability to identify and flag edge cases or policy exceptions in automated workflows. - Strong collaboration skills with cross-functional (engineering, compliance, and data) teams. ### **Engagement Model** - **Contract / Part-time (Remote/In person)** - Flexible hours with collaboration during U.S. business hours. In person in San Francisco is a plus
    $64k-87k yearly est. 17d ago
  • LABOR AND DELIVERY RN - TRAVEL NURSING

    LRS Healthcare-Nursing 4.3company rating

    Utilization review nurse job in Boston, MA

    LRS Healthcare - Nursing is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in Brighton, MA. Shift: Inquire Start Date: 12/15/2025 Duration: 13 weeks Pay: $2687 / Week Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24/7 support, and a responsive, traveler-first culture. Health, Dental, and Vision Insurance ~ Customized Housing Options ~ Life and Disability Insurance ~Certification & Licensure Reimbursement ~ Generous Referral Bonus Program ~ Weekly Direct Deposit ~Apply today to start your Travel Adventure with LRS Healthcare! About LRS Healthcare - Nursing: At LRS Healthcare, we match skilled nursing professionals with top facilities nationwide. We know the healthcare industry never stands still, and neither do we. Our team of specialized recruiters professionals will help you find the travel healthcare job you've always wanted.
    $2.7k weekly 13h ago
  • RN-Hospice Travel Nursing

    Coast Medical Service

    Utilization review nurse job in Norwood, MA

    Coast Medical Service is seeking an experienced Hospice Registered Nurse for an exciting Travel Nursing job in Norwood, MA. Shift: 5x8 hr days Start Date: ASAP Duration: 13 weeks Pay: $2653 / Week Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experienced or first-time traveler. Coast is featured on Blue Pipes' 2023 Best Travel Agencies and named a 2022 Top Rated Healthcare Staffing Firm & 2023 First Half Top Rated Healthcare Staffing Firm by Great Recruiters. Please apply here or contact a recruiter directly to learn more about this position & the facility, and/or explore others that may be of interest to you. About Coast Medical Service: Coast Medical Service is a customer driven healthcare staffing company focused on per diem and travel nursing opportunities in Greater Los Angeles. At Coast, we pride ourselves on our unrelenting commitment to customer service, allowing nurses and hospitals to focus on what they do best: providing world class healthcare to patients. Since 1979, Coast Medical Service has worked hard to provide RN's a professionally and financially rewarding experience in a personally fulfilling work environment. We are fanatical about improving the quality of healthcare. Our RN's can enjoy many benefits, including: Flexible Schedule High Pay Work alongside top professionals in world class facilities
    $2.7k weekly 13h ago
  • Night Shift ICU RN - Travel Nursing Contract

    Fusion Medical Staffing 4.3company rating

    Utilization review nurse job in Boston, MA

    Fusion Medical Staffing is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Boston, MA. Shift: Inquire Start Date: 01/12/2026 Duration: 13 weeks Pay: $2254 / Week Travel ICU RN Fusion Medical Staffing Facility in Boston, Massachusetts Job Details Fusion Medical Staffing is seeking a ICU RN for a 13-week travel assignment in Boston, Massachusetts. One year of recent experience as an ICU RN Valid RN license in compliance with state regulations Critical Care Registered Nurse (CCRN) certification Summary: The ICU Registered Nurse is responsible for providing comprehensive, critical care to patients in the intensive care unit. This role encompasses assessing and monitoring critically ill patients, operating life-support equipment, administering advanced treatments, and collaborating with multidisciplinary healthcare teams. The position requires strong critical care skills, advanced clinical judgment, excellent communication, and a commitment to maintaining the highest standards of patient safety and professional ethics in high-acuity settings. Administer complex medications and treatments in accordance with approved critical care nursing techniques Operate and manage advanced life support equipment Ensure patient safety and comfort in high-acuity ICU environments, addressing physical and emotional needs Perform and interpret advanced hemodynamic monitoring, including arterial lines, central venous pressure, and pulmonary artery catheters Accurately document all assessments, interventions, and patient responses in the medical record in a timely manner to ensure continuity of care and compliance with regulatory standards Provide education to patients and families regarding the ICU environment, treatments, and recovery expectations Communicate closely with interdisciplinary healthcare teams to optimize patient care Maintain proficiency in critical care procedures and technologies through ongoing education and training Adhere to strict infection control protocols to protect immunocompromised patients and reduce risks Engage in quality improvement initiatives to enhance ICU patient outcomes and operational efficiency Adhere to hospital safety protocols, infection control guidelines, and regulatory standards The ability to read, write, and communicate in the English language Physical Abilities - Must be able to remain in a stationary position, move about, move equipment (50-100lbs), push, pull, and bend Technical/Motor Skills - Must have the ability to grasp, perform fine manipulation, push/pull, and move about when assisting with procedures and/or using department equipment Mental Requirements - Must be able to cope with frequent contact with the general public and customers while meeting deadlines under pressure. Must be able to work under close supervision occasionally, as well as working without assistance from other personnel. Sensory - Must possess visual acuity and ability to effectively communicate Highly competitive pay for travel professionals ~ Comprehensive medical, dental, and vision insurance with first day coverage ~ Life and Short-term disability offered ~Aggressive Refer-a-friend Bonus Program ~Reimbursement for licensure and CEUs At Fusion Medical Staffing, our goal is to improve the lives of everyone we touch, and we're always looking for people like you to join our mission. Your passion for helping others deserves a partner just as committed to supporting you - that's why we offer day one insurance, $0 copay for mental health services, scholarships and awards, exclusive discounts, and more. From your personal recruiter to our clinical and traveler experience teams, we're here to guide and celebrate you along your journey. You take care of others; we take care of you. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Start your rewarding career as a Travel ICU RN with Fusion Medical Staffing and join our mission to improve lives. Fusion is an EOE/E-Verify Employer About Fusion Medical Staffing: Fusion Medical Staffing provides career opportunities to healthcare professionals by helping medical facilities fill their staffing needs. Fusion staffs a variety of specialties within the nursing and allied healthcare fields. Specialty Fields: Home Health Long Term care Nursing Radiology Therapy
    $2.3k weekly 13h ago
  • LABOR AND DELIVERY RN - TRAVEL NURSING

    Atlas Medstaff 3.7company rating

    Utilization review nurse job in Newburyport, MA

    Atlas MedStaff is seeking an experienced Labor and Delivery Registered Nurse for an exciting Travel Nursing job in Newburyport, MA. Shift: 3x12 hr nights Start Date: 12/29/2025 Duration: 13 weeks Pay: $2448.16 / Week Scroll down to find an indepth overview of this job, and what is expected of candidates Make an application by clicking on the Apply button. Atlas Medstaff is currently seeking candidates in the RN, Labor and Delivery profession for a 13 week contract in the Newburyport, Massachusetts area. Our commitment to excellence and our consultative approach has helped us become a premier leader in the staffing industry. *Estimated compensation package based on a usual week of work, inclusive of taxable hourly wage and expected weekly travel expenses. The payment package is not a guaranteed salary or promise of payment, and does not include taxes, insurance, or other deductions that may occur. Comprehensive Health, Dental and Vision insurance. Telehealth services for ease of use when an office visit isn't feasible. Voluntary Term Life and Dependent Life coverage as well as In Hospital Cash Plans. We think your recruiter and your travel healthcare agency should care about you. Like co-founders who are transparent, a tight-knit community for our travelers, creating content that tells *your* story, and helping you find adventure. Skiing, mountain climbing, skydiving, or even just a weekend at a spa or tickets to a concert you can't wait for. We have been ranked #1 by BluePipes as the best travel healthcare agency. And received the distinction of being the highest-rated travel healthcare staffing agency by Great Recruiters. Both of those recognitions are fueled by real reviews by real travel nurses and allied healthcare professionals that work with our team. the fastest-growing staffing company in the country, and the fastest-growing healthcare staffing company in the country by Staffing Industry Analysts; You may not be in the office (heck, we're not either since a lot of our team has been working remote since the pandemic), but you are part of the Atlas Community. xevrcyc If you don't have this kind of relationship with your current recruiter and travel nurse agency, maybe it's time you try one that's a little bit different.
    $2.4k weekly 1d ago
  • Care unit travel nurse

    Cynet Health 4.5company rating

    Utilization review nurse job in Pittsfield, MA

    Cynet Health is seeking an experienced Coronary Care Unit Registered Nurse for an exciting Travel Nursing job in Pittsfield, MA. Shift: 3x12 hr nights Start Date: 12/22/2025 Duration: 13 weeks Pay: $2436 / Week Maximise your chances of a successful application to this job by ensuring your CV and skills are a good match. About Cynet Health: Ranked #5 Best Travel Nursing Companies 2022 by BluePipes. We offer the most competitive pay for every position we fill. We understand this is a partnership. You will have no surprises. xevrcyc Your salary will be discussed upfront and there will be no troubling negotiation tactics. Chat live with one of our recruiters 24x7 on our website @ or schedule a call
    $2.4k weekly 1d ago
  • Medical/Surgical - MedSurg RN - Travel Nurse

    Travel Nurse Across America 4.5company rating

    Utilization review nurse job in Pittsfield, MA

    We're looking for Medical Surgical RNs for an immediate travel nurse opening in Pittsfield, MA. The right RN should have 1-2 years recent acute care experience. Read below for more requirements. As a MedSurg RN, you will conduct patient assessments and prioritize data collection based on patients' immediate conditions or needs. MedSurg RNs perform ongoing assessments and appropriate treatments as ordered by a physician. Documenting patient findings and providing education and support to patients' families is essential to this travel nurse position. As a Medical Surgical Travel Nurse, you should be prepared to perform the following tasks: Provide bedside care for a variety of patients, including pre- and post-op patients. Prepare, administer and record prescribed medication, reporting any adverse reactions to treatment. Change dressings, insert catheters and start IVs. Prepares equipment and aids physician during examination and treatment of patient. Educates patients on surgical procedures. Participates in discharge planning and initiates patient education plan as prescribed by physician. Medical Surgical Travel Nurses should be able to stand and walk for long periods of time, as well as bend, lean and stoop without difficulty. RNs should be able to easily lift 20 pounds. Moving or lifting of patients may require lifting of up to 50 pounds at times. RNs will work in a fast-paced environment treating patients that may be confused, agitated, and/or uncooperative. Requirements*: BLS, ACLS, NIH, 2 Years * Additional certifications may be required before beginning an assignment.
    $85k-177k yearly est. 4d ago
  • Per Diem Staff RN Night Shift

    KPG Healthcare Nursing

    Utilization review nurse job in Barnstable Town, MA

    KPG Healthcare Nursing is seeking an experienced Medical Surgical Registered Nurse for an exciting Travel Nursing job in Hyannis, MA. Shift: Inquire Start Date: ASAP Duration: 13 weeks Pay: $2240 / Week Travel Med Surg Registered Nurse - $2,240 per week in taxable pay and non-taxable stipend amount. Pay rates are subject to confirmation with tax free stipend determined for qualified candidates. KPG Healthcare is currently seeking an experienced Med Surg Registered Nurse for a travel. The ideal candidate will possess an active RN License with 2 or more years of experience. Location - Hyannis, Massachusetts Requirements for a Travel Med/Surg Registered Nurse: ~ Active RN License for this state ~What KPG Healthcare has to offer: ~12 hour shifts, 36 hours per week ~ Housing or Housing stipend provided ~ Travel and License reimbursement ~ Healthcare benefits ~ Weekly Pay with direct deposit About KPG Healthcare: KPG Healthcare is a Staffing Firm that provides diverse Supplemental and Permanent Healthcare Staffing solutions to a wide range of Clients throughout the Nation. Our Services include Travel Nursing, Home Health, Allied Professionals, Locum Tenens Staffing, and Physician Placements. The primary factor differentiating KPG Healthcare from other recruitment firms is the quality of our experience, the breadth of our industry network, and the creativity that we apply to finding the perfect placement options. Throughout our partnership with you, we will excel at providing friendly personal attention and producing outstanding results. About KPG Healthcare Nursing: We work tirelessly to provide high quality, rewarding employment opportunities for our Healthcare Professionals. At KPG Healthcare, we pride ourselves on service. We work hard to find the best and most fulfilling Travel Nursing, Per Diem and Allied Health assignments. Our Staffing Specialists will provide you personal attention while striving to find the assignment you are looking for. Whether it is a short- or long-term contract or picking up extra shifts, we have options for you.
    $15k-63k yearly est. 13h ago
  • Utilization Review RN

    Aura Staffing Partners

    Utilization review nurse job in Cambridge, MA

    Benefits: Direct Deposit Weekly Pay Competitive salary Inpatient RN - Utilization Review Nurse (Behavioral Health) - Cambridge, MA Schedule: Day Shift, Monday-Friday, 8:30 AM - 5:00 PM Pay: $72/hour Job Summary: We are seeking a skilled Inpatient RN Utilization Review Nurse to join our behavioral health team in Cambridge. This role focuses on acute care review and utilization management to ensure high-quality patient care. Requirements: Must be a local candidate within 50 miles of Cambridge, MA Acute care experience required Experience with InterQual criteria EMR experience required (EPIC preferred) Strong clinical judgment and utilization review skills Responsibilities: Review and evaluate patient care for appropriateness and efficiency Collaborate with interdisciplinary teams to support patient care and discharge planning Ensure compliance with hospital policies and clinical guidelines Apply now to join a team dedicated to delivering exceptional behavioral health care. Compensation: $72.00 per hour Great jobs. Great company. Great community of caregivers. At Aura Staffing Partners, we know that partnering with you to find the right opportunity in healthcare is just the beginning. We don't leave you high and dry, instead we help you grow even brighter with quarterly reviews, continued training and plenty of communication.
    $72 hourly Auto-Apply 48d ago
  • Nurse Reviewer I

    Elevance Health

    Utilization review nurse job in Woburn, MA

    Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: 9:30am-6:00pm local time, with rotating weekends. New Grads are encouraged to apply! The Nurse Reviewer I will be responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. * Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. * Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. * Partners with more senior colleagues to complete non-routine reviews. * Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment. How you will make an impact: * Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review. * Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network. * Notifies ordering physician or rendering service provider office of the preauthorization determination decision. * Follows-up to obtain additional clinical information. * Ensures proper documentation, provider communication, and telephone service per department standards and performance metrics. Minimum Requirements: * AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. * Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities, and Experiences: * Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred. * BA/BS degree preferred. * Previous utilization and/or quality management and/or call center experience preferred. * Knowledge in Microsoft office. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $33.12/hr - $56.77/hr Locations: New York, New Jersey, Washington, Nevada, Maryland, Massachusetts, Illinois, District of Columbia In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Non-Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $33.1-56.8 hourly 1d ago
  • Staff Nurse RN- PT Days

    Hebrew Seniorlife 4.1company rating

    Utilization review nurse job in Dedham, MA

    The Registered Nurse (RN) will utilize the nursing process of assessment, planning, implementation, and evaluation to ensure quality-nursing care and to maximize the quality of life for the patients. The RN is an integral member of the clinical support team, and collaborates with other multidisciplinary members to meet the clinical needs of the patients. The RN is an active supporter of the culture change initiatives, and serves as a role model and mentor to others. In addition, the RN will demonstrate a strong commitment to the philosophy and mission of Hebrew SeniorLife and recognize patient's dignity and choice in all aspects of daily life. They are an active participant in the activities, work, and social environment of the units, and strive to make every patient encounter into a positive and meaningful experience and opportunity, while ensuring the provision of safe and efficient quality care. II. Core Competencies: Demonstrates empathy and compassion with all interactions with patients and with families Articulates importance of supporting independence and patient choice when caring for patients Demonstrates strong communication skills and ability to foster teamwork Articulates commitment to excellence and high quality care Articulates the importance of accountability and personal ownership related to teamwork and patient care Demonstrates strong critical thinking skills Demonstrates ability to coach and mentor others to achieve high quality care III. Position Responsibilities: Ensures all care delivered is within the scope and established standards of safe professional nursing practice and HSL core competencies Collaborates with other members of the clinical support team (MD, NP, nurses, social worker, therapists, dietician) to meet the clinical needs of the patient and monitor outcomes of care Adheres to best practice recommendations and implements evidence based interventions to ensure optimum outcomes for patients Practices in a primary nursing model and maintains accountability for a set of assigned patients Collaborates and participates in care planning activities and supports autonomy and individual choice wherever possible Ensures adherence to the plan of care, revises as necessary, and ensures the plan accurately reflects an individualized approach to patient's needs Documents appropriately in the electronic medical record Identifies and seeks out necessary resources as needed to ensure the provision of safe and effective care Delegates and supervises clinical care delivered by the licensed practical nurse and the nursing assistant Assumes accountability for his/her own learning needs and professional development Demonstrates critical thinking abilities in problem resolution Role models professional behavior Actively participates in shared governance, committees, etc Collaborates in the development of new work processes and systems Serves as a resource and support to the elder assistants in the units Identifies and responds to safety concerns on the unit and neighborhood Maintains compliance with policies, procedures, practice and regulatory matters Participates in the collection and monitoring of quality data to ensure high standards of care Participates in performance improvement projects Participate and assists with activities (i.e. assist with serving meals) Serves as a coach and mentor to all staff, i.e. PCAs and LPNs May be assigned charge nurse responsibilities. Responsibilities may include: Giving shift report to on coming staff Provide clinical/supervisory oversight to assigned unit during shift Delegate assignments to team assigned to shift Initiate necessary reports including DPH, incident reports, concern resolutions Assure completion of admission or discharges during shift Attend rounds (wound, physician etc) Provides oversight of LPN assessments (as assigned) and co-signs nursing assessments and initial care plans. If acting in the capacity of charge nurse, may develop patient care assignments (appointing other staff, RN, LPN or PCA to implement an established care plan for a designated period of work time), create schedules, and contribute to performance evaluations and educating other staff on HSL policy and procedure. The above covers the most significant responsibilities of the position. It does not, however, exclude other duties, which would be in conformity with the level of the position. Completes special projects as assigned. IV. Qualifications: Graduate of approved school of nursing required; BSN preferred Current Massachusetts license as an R.N. in good standing Previous experience preferred Understand the philosophy and support the model of care at HRC required Must be professional, proactive, collaborative, conscientious and results-oriented individual. Must have an optimistic and positive demeanor, excellent oral and written communication skills, good intuition and able to adapt to changing priorities and display good, sound judgment with a sense of humor. Superb organizational skills. Must have solid analytical skills. Must be creative and proactive yet disciplined, discriminating and able to streamline work volume in order to maintain bottom line efforts in midst of multi-tasking and daily re-prioritizing. Must have ability to innovate, think strategically and conceptually, manage multiple projects simultaneously and handle even difficult situations. Must be motivated to learn and flexible to change Computer literacy required Excellent English language skills, written and verbal V. Physical Requirements: Please refer to the Physical Requirements sheets in Occupational Health Remote Type Salary Range: $32.13 - $48.20
    $32.1-48.2 hourly 4d ago
  • Utilization Management Nurse

    Centerwell

    Utilization review nurse job in Boston, MA

    **Become a part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. **Use your skills to make an impact** **Required Qualifications** + Active unrestricted RN license with the ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work independently and within a team setting + Willing to work in multiple time zones + Strong written and verbal communication skills + Attention to detail, strong computer skills including Microsoft office products + Ability to work in fast paced environment + Ability to form positive working relationships with all internal and external customers **Preferred Qualifications** + Education: BSN or bachelor's degree in a related field + Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual **Alert** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Interview Format - HireVue** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Benefits** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $71.1k-97.8k yearly Easy Apply 22d ago
  • Nurse Manager - Case Management

    Amergis

    Utilization review nurse job in Barnstable Town, MA

    Amergis Healthcare Staffing is partnered with a much-respected facility in Hyannis, MA who is currently seeking a qualified Nurse Manager to assist them on a contractual basis. Nurse Manager - Clinical Resources/Case Management Location: Hyannis, MA Facility Type: Hospital Start: 12/29 Duration: 13 weeks Hours: 40 Shifts: + M-F Days Requirements: + Permanent MA RN license + 5+ years Case Management experience + Managerial/Supervisory experience I hope to connect soon! If the job specifications don't match your preferences, please feel free to get in touch and share more about what you're looking for. Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: + Competitive pay & weekly paychecks + Health, dental, vision, and life insurance + 401(k) savings plan + Awards and recognition programs *Benefit eligibility is dependent on employment status. About Amergis Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions. Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
    $70k-100k yearly est. 2d ago
  • Enterostomal Nurse

    Massachusetts Eye and Ear Infirmary 4.4company rating

    Utilization review nurse job in Salem, MA

    Site: North Shore Medical Center, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Description - External The wound ostomy continence (WOC) Nurse assumes roles of clinician, consultant, change agent, educator, and participates in research activities. They provide expert clinical consultation and education to nurses, family, patient, and RC regarding their responsibilities for coordinating all aspects of managing and delivering quality, cost effective patient and family centered care specifically in the areas of wound ostomy and continence. The WOC Nurse collaborates with the nurse and RC to assure that all patients have a comprehensive plan of care that provides continuity across all settings. The WOC Nurse acts as a resource to the nurse in providing patient/family education. The WOC Nurse evaluates the quality of care through data analysis, direct observation, chart review, and collaboration with the health care team, administrators, nursing quality, and wound care collaboratives. Qualifications - External Required: • Completion of Debridement Workshop. • Medium physical demands including constant standing, walking, hearing and vision, intermittent bending, pushing, pulling, carrying, lifting, and lowering of 20-50 pounds of force. • Satisfactory completion of a pre-employment physical examination • Three to five years of relevant clinical experience. • Bachelor's Degree from an accredited School • Graduate from an accredited School of Nursing. • Current License to practice as a Registered Nurse in the Commonwealth of Massachusetts • Current Wound and Ostomy certification by a nationally accredited certifying body (WOCNCB preferred). Preferred: • WOCNCB sets the standard for wound, ostomy, and continence nursing certification by validating nurses' knowledge to provide safe, patient-centered care. Qualifications Education Other Certificate/Diploma Nursing required or BSN preferred Licenses and Credentials Valid and current license to practice as an RN in the Commonwealth of Massachusetts. Experience 3+ years Wound care experience preferred. Knowledge, Skills and Abilities - Perform this job successfully within the scope of nursing, an individual must be able to perform each essential duty satisfactorily and be able to demonstrate any knowledge and skills necessary to provide care appropriate to the age of the patients serviced in his/her assigned department Certifications in CPR, or PALS, ACLS, and BLS may be required upon hire for specific patient care units. Additional Job Details (if applicable) Physical Requirements Standing Frequently (34-66%) Walking Frequently (34-66%) Sitting Occasionally (3-33%) Lifting Frequently (34-66%) 35lbs+ (w/assisted device) Carrying Frequently (34-66%) 20lbs - 35lbs Pushing Occasionally (3-33%) Pulling Occasionally (3-33%) Climbing Rarely (Less than 2%) Balancing Frequently (34-66%) Stooping Occasionally (3-33%) Kneeling Occasionally (3-33%) Crouching Occasionally (3-33%) Crawling Rarely (Less than 2%) Reaching Frequently (34-66%) Gross Manipulation (Handling) Frequently (34-66%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) Remote Type Onsite Work Location 81 Highland Avenue Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $37.40 - $90.18/Hourly Grade RN1450 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: North Shore Medical Center, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $37.4-90.2 hourly Auto-Apply 24d ago
  • Nurse Coordinator (PHN-10)

    Internships.com 4.1company rating

    Utilization review nurse job in Boston, MA

    Under direction of Head Nurse and/or Program management, plays a leadership role in the investigation and follow-up of communicable disease cases/outbreaks or other situations of public health concern. Performs and oversees communicable disease surveillance, prevention and control measures according to protocols for cases/outbreaks as assigned. In conjunction with other Division staff, identifies patterns of communicable diseases and related risk factors, and provides health education and outreach as needed for communicable disease prevention and control. This nursing leadership position ensures high quality nursing practice within the CDC Division, by overseeing clinical nursing activities and directing and evaluating the professional practice of nurses, according to established standards of care. This position is also expected to work with the nursing leadership to develop standard operating procedures and workflows for case and outbreak investigations and contact tracing efforts. Investigates and provides care and follow-up of contagious diseases including COVID-19. Vaccinates against contagious diseases including COVID-19. In conjunction with other Division staff, identifies patterns of communicable diseases and related risk factors, and provides health education and outreach as needed for communicable disease prevention and control. Assists with development of data collections tools and ensures complete and accurate collection of data. Supervises subordinates as required. Assists in orientation of new staff, program visitors and in staff development programs. Identifies or develops resources as needed for case or outbreak follow-up. Provides nursing support for CDC Division activities, including vaccine and other clinics or other projects or activities as needed. Provides nursing services at the TB Clinic, including phlebotomy, patient assessment, patient/family/significant other education, medication monitoring, and skin testing. Participates in special projects and initiatives as requested and acts as clinical back-up for special projects. Participates in staff conferences, research activities, meetings with community based or other agencies as requested. Plays a key role in communicable disease related epidemiologic activities. Plays a key role in providing education and outreach on communicable disease issues to health care providers, agencies, and community groups throughout the city. Acts as a resource on communicable disease related issues for division staff, providers, and community groups. Collaborates with others throughout the Division to ensure public health preparedness for bioterrorism and other communicable diseases. May be required to perform duties of other CD or TB nurses. Performs other duties as required. Works to help BPHC advance as an antiracist organization by meeting or exceeding the standards set by the BPHC Anti-Racism Policy.
    $88k-113k yearly est. 1d ago
  • Substitute Nurse

    Acton-Boxborough Regional School District 3.9company rating

    Utilization review nurse job in Massachusetts

    Substitute/Substitute Nurse Date Available: On Call Basis Closing Date: until filled Salary: $200/day Description of Duties: Triages students and staff with an injury, illness or accident and provides appropriate intervention, following protocols, procedures, and policies. Maintains a daily record of all health office services, documenting the administration of all medications in accordance with medication policy and state regulations. Will receive ongoing training and support from nurse leader. Qualifications: Massachusetts RN licensure Application Procedure: Apply online We believe that our students deserve to learn from educators who reflect their backgrounds and life experiences, and we want our staff to reflect the wide range of student identities we seek to serve. To this end, our District is committed to increasing the diversity of our certified educators and leaders. We believe that by building a more representative workforce, our students will have better outcomes and be more prepared for an increasingly diverse world. We encourage the following to apply: candidates of color, individuals with diverse life experiences and non-traditional backgrounds, and allies in our diversity, equity, and inclusion work.
    $200 daily 60d+ ago
  • Wellness Nurse Per Diem

    Brigham House 3.9company rating

    Utilization review nurse job in Watertown Town, MA

    Full-time, Part-time Description Job Title: Wellness Nurse Hours: Per Diem The Resident Care Nurse is responsible for assisting the Resident Care Director with the overall implementation, delivery and coordination of Resident Care services at the Community. Nurse will also assist in monitoring the medication management program. Duties and Responsibilities: The following essential functions are the fundamental job duties of the position to be completed with or without appropriate reasonable accommodation. • Assist in supervising the medication program and assisting the residents with self-administration of their medication. • Assist residents with Activities of Daily Living and Independent with Activities of Daily Living as needed. • Maintain positive relations with residents, families and physicians. • Report any significant incidents and/or changes in the residents needs to the Executive Director/Resident Care Director. • Assist in the completion of resident assessments and services plans. • Assist in the training of assisted living staff and participates in orientation of new staff. • Attend and participates in scheduled in-service programs, training programs and staff meetings. • Assist with scheduling and staffing of Resident Care Assistants • RN will maintain GAFC. • May perform other duties as assigned. Requirements Minimum Qualifications: • Registered Nurse/Licensed Practical Nurse/Licensed Vocational Nurse with a current license in good standing. • Certification or licensed per state guidelines. • Must successfully complete all HallKeen • Community specified training programs. • Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations. • Able to work various schedules and shifts as needed. • Required Behavior: • Appearance is neat, clean, and according to dress code. • Able to demonstrate a high level of service delivery; does what is necessary to ensure customer satisfaction; deals with service failures and prioritizes customer needs. • Able to clearly present information through the spoken word; reads and interprets complex information; talks with residents, family members and customers; listens well. • Able to communicate with others in a warm and helpful manner while simultaneously building credibility and rapport. • Able to work cooperatively with a group of people to achieve goals and objectives. • Able to be tactful; maintains confidences, and fosters an ethical work environment; prevents inappropriate behavior by coworkers; gives proper credit to others; handles all situations honestly. • Able to keep an open mind and change opinions on the basis of new information; performs a variety tasks and changes focus quickly as demands change; manages transitions effectively from task to task; adapts to varying customer needs. Physical Demands: • Physically able to move at least 50 lbs. without assistance. • Physically able to bend, reach, and work in small areas. • Physically able to push and pull equipment and furnishings. • Physically able to stand for long periods of time.
    $64k-83k yearly est. 18d ago
  • NP/PA - Hospital Medicine Unit - MGH

    Brigham and Women's Hospital 4.6company rating

    Utilization review nurse job in Boston, MA

    Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Every Weekend Requirement This position is an every weekend position and candidates may decide between either a full time (36 or 40h) employee. The weekend shifts are each 12-hour shifts. This innovative opportunity is for a Nurse Practitioner (NP) to collaborate with attending hospitalists on the Hospital Medicine Unit at the Massachusetts General Hospital. This opportunity includes direct patient care from admission to discharge and a cross-coverage model for general inpatient medicine patients and subspecialty services. Each NP will follow 6 patients on average, with one admission per day. The NP promotes a collaborative relationship and effort between the hospitalists, private physicians, nurses, and the remainder of the interdisciplinary health care team. Applicants for this position should be patient-centered, motivated, and energetic clinicians that want to be part of a large academic team with MD/DO colleagues and NP/PA peers. The ideal candidate must be a self-starter and able to respond, triage, and systematically care for both non-urgent and acute issues that arise in our patients. Job Summary The Nurse Practitioner (NP) is a licensed provider. The NP is responsible for the assessment and management of various populations of patients, medical and/or surgical, including diagnostic and therapeutic interventions, development of appropriate plans of care and ongoing evaluation. Does this position require Patient Care? Yes Essential Functions * Provides direct care, counseling, and teaching to a designated patient population in the ambulatory, inpatient, operative, and/or procedural setting * Performs complete histories and physical examinations * Orders, interprets, and evaluates appropriate laboratory and diagnostic tests * Develops appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings * Consistently provides high quality and timely documentation including admission and progress notes, procedure notes, operative notes and discharge summaries * Performs bedside procedures as are appropriate to the patient population * Orders medications and writes prescriptions according to organizational and regulatory policies and procedures Qualifications Education Master's Degree Nursing required Can this role accept experience in lieu of a degree? No Licenses and Credentials Registered Nurse MA Nurse Practitioner MA Experience Experience as a Nurse Practitioner 0-1 year preferred Knowledge, Skills and Abilities * Skilled in taking medical histories to assess medical condition and interpret findings. * Ability to maintain quality control standards. * Ability to react calmly and effectively in emergency situations. * Ability to interpret, adapt and apply guidelines and procedures. * Ability to communicate clearly and establish/maintain effective working relationships with patients, medical staff and the public. Additional Job Details (if applicable) Remote Type Onsite Work Location 55 Fruit Street Pay Range $120,390.40 - $170,456.00/Annual Grade 7 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $120.4k-170.5k yearly Auto-Apply 9d ago
  • Substitute Nurse Pool (SY25-26)

    Boston Public Schools 4.5company rating

    Utilization review nurse job in Boston, MA

    Reports to: Health Administrator General Description: The substitute school nurse provides skilled nursing care and management of the special needs of students as well as medication administration. Routine emergency care is provided for students and staff. If necessary, students are referred to their primary health care provider for an evaluation. For students with complex medical needs, the substitute school nurse may act as a liaison for the school, home, and outside medical facilities. The substitute school nurse promotes student wellness and assists in maintaining a healthy school environment. Experience in: support services in a school setting; liaison and case management; high-risk, multi-problem children and adolescents Responsibilities: 1. Provides emergency medical care to students. 2. Administers and supervises the administration of prescription medication to students. 3. Counsels and educates students in small groups or as individuals concerning medical issues. 4. Conducts formal and informal evaluations of medical conditions and develops accurate medical summaries on students. 5. Teach mini-courses to small groups of students in medical or health areas related to survival skills. 6. Monitors and assesses compliance with immunization standards as per BPS and DPH regulations. 7. Performs vision, hearing, scoliosis, dental, and other health-related screenings as required by DPH or BPS school health services. 8. Develops and maintains contacts with medical persons or facilities that might provide direct service or consultation. 9. Engages in Service Team Meetings with students when they require medical input, interpretation, or consultation. 10. Establishes and maintains appropriate record-keeping and reporting formats and procedures. 11. Conducts formal workshops and informal training for staff as appropriate. 12. Maintains adequate and updated health records. 13. Serves as medical representative to evaluations and re-evaluations and obtains and interprets medical evaluations at these meetings. Qualifications Required: 1. Bachelor of Science in Nursing 2. Massachusetts license as a Registered Nurse 3. MA State Dept. of Education School Nurse License. 4. CPR & First Aid Certification 5. Experience working with children and adolescents in public school/agency/human services setting Current authorization to work in the United States-Candidates must have such authorization by their first day of employment Preferred: The terms for the position include BTU, and the daily rates for Substitute Nurses may vary. Daily rates range from $371.59 to $385.30 dependent upon the school and length of the assignment. https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:a0***********-4b59-843a-b29e104960af?viewer%21megaVerb=group-discover
    $82k-103k yearly est. 60d+ ago
  • Per Diem Nurse

    Country Club Heights 4.2company rating

    Utilization review nurse job in Woburn, MA

    Licensed Practical Nurse (LPN/LVN) We are seeking a skilled Licensed Practical Nurse (LPN/LVN) to join our healthcare team at our senior living community. The LPN will be responsible for providing direct patient care under the supervision of a registered nurse or physician. The LPN will also be responsible for administering medications, monitoring vital signs, assisting with patient assessments and care plans, and overseeing the patient care provided by caregivers. Designed and purpose built for seniors, our communities incorporate resort-style amenities and social activities to provide seniors a carefree, maintenance-free lifestyle, while providing best in class care. Our Brands deliver a variety of lifestyles: cottages, senior apartments, and independent living, assisted living and memory care in different locations. Most important, our residents love living with us, and you will love working with us. At Aviva Senior Living, we are committed to providing a supportive and engaging environment. Our dedicated staff is passionate about ensuring that each resident feels at home, offering personalized care and assistance as needed. Our beautifully designed units and welcoming atmosphere create a space where residents can thrive and enjoy life to the fullest. Join us at Aviva Senior Living and be part of a community that prioritizes the well-being and happiness of our residents, fostering a sense of comfort, connection, and joy every day. This position makes a difference to our residents' overall well-being and happiness and brings peace of mind to families that their loved ones are cared for and treated well Shift Details: We are currently searching for an LPN to join our shifts. Please note, this may change throughout employment as needed with notice. Primary Responsibilities: Administer medications and treatments as prescribed by a physician or registered nurse Monitor and record vital signs, such as blood pressure, temperature, and pulse Assist with patient assessments and care plans Provide direct patient care, including bathing, dressing, and feeding Assist with diagnostic tests and procedures Document patient care and progress in medical records Communicate with patients and their families about care plans and progress Collaborate with other healthcare professionals to provide comprehensive patient care Qualifications, skills, and abilities: Active LPN license valid in the State position is located. Minimum of 1 year of experience as an LPN Excellent communication and interpersonal skills Ability to work independently and as part of a team Strong attention to detail and organizational skills Ability to prioritize and manage multiple tasks Basic computer skills Ability to treat residents, families and team members with respect and compassion. Full-time employees can take advantage of: Medical/Prescription Insurance Dental Insurance Vision Insurance Paid time off accrued up to 15 days per year. Paid Holidays Employee Referral Program Company Paid Life Insurance Pet Insurance available Company matching 401k Available pay advance (daily pay) (Available to all employees) Aviva Senior Living is an Equal Opportunity Employer and a Drug-Free Workplace. JOB CODE: 1000473
    $55k-68k yearly est. 60d+ ago

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Top 9 Utilization Review Nurse companies in MA

  1. University of Massachusetts Medical School

  2. Centerwell

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  4. UnitedHealth Group

  5. Verisk Analytics

  6. University of Massachusetts Boston

  7. Beth Israel Lahey Health

  8. Aura Staffing Partners

  9. Mercor

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