OTP Full Time Dispensing Nurse
Utilization review nurse job in Boston, MA
*Full Time Dispensing Nurse - * *RN/LPN* *Don't miss out on this opportunity to grow your career and enjoy *free garage parking* in a secure, convenient location!* * Health Care Resource Center *is looking for a detail oriented and empathetic Licensed Practical Nurse to dispense prescribed medications as part of a treatment team in partnership with Physicians and Nursing Supervisors. The dispensing nurse also shares responsibility of maintaining dispensing equipment, managing medication inventory and reporting patient treatment information.
An ideal dispensing nurse candidate works cooperatively with supervisory counseling staff and demonstrates a non-judgmental and accepting attitude toward the Substance Use Disorder.
*Responsibilities: *
* Administer daily medication to patients in accordance with program policy and medical protocols. *
* Use automated dispensing system(s), calibrate pump and maintain dispensing equipment
* Produce and maintain appropriate records and reports as required by Company protocol, Federal and State Regulations
* Ensure compliance with security standards for the distribution and storage of controlled substances as set forth in the Code of Federal regulations
* Order, receive and stock medication in accordance with DEA and State regulations. (If granted Power of Attorney)
* Provide daily assessment of patients
* Assist Nursing Supervisor to orient new nursing staff
* Other related duties as determined by supervisor
*Qualifications: *
* Current & good standing Registered Nurse or Licensed Practical Nurse license in the State of Massachusetts *
* Current CPR certification required
* EMR & computer proficiency desired
* Experience in chemical dependency preferred, self-motivated and directed, must have a positive attitude toward individuals in substance abuse treatment.
* Satisfactory drug screen and criminal background check.
*Salary Range: *
Salary ranges from $32.00 to $35.00 an hour.
The salary of the candidate(s) selected for this role will be set based on a variety of factors, including but not limited to, experience, education, specialty, and training.*
*BayMark offers excellent benefits:*
* 401K match
* Medical, Dental, Vision Insurance
* Voluntary Worksite Benefits (i.e., Accidental Injury)
* Company paid Short & Long Term Disability
* Company paid Basic Life Insurance
* Paid Time Off
* Bereavement Leave
* Flexible Sick Time
* Employee Referral Program
* BayMark Perks Program
* Jury Duty & Witness Duty Leave
* BayMark University Learning
* *
*Here is what you can expect from us:*
* Health Care Resource Center*, a progressive substance abuse treatment organization, is committed to the highest quality of patient care in a comfortable outpatient clinic setting. Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.
* Health Care Resource Center* is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.* *
Nurse for Residential Treatment Facility
Utilization review nurse job in Derry, NH
Per Diem Nurse - Licensed Practical Nurse Granite Recovery Center is looking for a Licensed Practical Nurse to care for our patients in our residential facility. Responsibilities: * Complete the admission procedures, which may include the completion of paperwork, orientation of the individual and monitor urinalysis collection.
* Thoroughly searches individuals' belongings upon admission and properly disposes of any forbidden items.
* Administer and read the tuberculosis skin test.
* Document in the individual's chart the results of the nursing assessment, treatment plan, physician's orders, progress notes and other individual-related data.
* Provide direct care to the individuals we serve.
* Monitors for signs and symptoms of intoxication and withdrawal.
* Provide medically monitored evaluation and withdrawal management to individuals served in the Detoxification Unit under the supervision of the Director of Nursing.
* Monitoring for changes in condition.
* Maintaining hygienic and safe work environment in compliance with the healthcare procedures.
* Maintain all necessary documentation.
* Update and maintain accurate Medication Administration Records.
* Manage and administer medication as ordered by the Medical Director.
* Providing directions to the technicians on assigned shift.
* Develop a treatment plan with the individual to address medical issues.
* Provide emotional support through listening, counseling and answering questions.
* Consult with in-house staff and other outside professionals to assure comprehensive, quality care for clients.
* Provide referrals for identified needs of the individual that cannot be met by the Agency.
* Maintains professional boundaries with clients and interacts with them in an appropriate manner.
* All other related duties as assigned.
Qualifications:
* Must hold an unrestricted RN license in the state of New Hampshire.
* Requires current certifications in CPR, First Aid and Bloodborne Pathogens.
* Must pass State of New Hampshire criminal background and driving record checks.
* Prefer 1 year of detox, emergency, or med-surge nursing experience.
* Prefer working knowledge of medical detoxification for substance abuse.
* Knowledge of the signs and symptoms of substance intoxication and withdrawal including pharmacological factors.
* Excellent customer service skills.
* Ability to work with a diverse population.
* Must have strong leadership, team building and communication skills.
* Ability to perform the physical demands of the position with or without reasonable accommodation where applicable.
* Must be able to physically respond to individuals' needs in the event of a crisis situation.
* Good verbal and written communication skills required.
* Knowledge of the American Society of Addiction Medicine placement criteria and the Diagnostic and Statistical Manual as it relates to substance-related disorders or able to acquire the knowledge.
* Knowledge of the Code of Ethics for nurses.
* Knowledge of the federal drug and alcohol confidentiality law (42 C.F.R. Part 2) and the Health Insurance Portability and Accountability Act.
* Ability to work a varied schedule to include evenings, weekends and/or holidays.
* Ability to establish and maintain effective working relationships with other employees, individuals served, outside professionals and the general public.
* Satisfactory drug screen and criminal background check
Here is what you can expect from us:
Granite Recovery Center, a progressive substance abuse treatment organization, is committed to the highest quality of patient care. Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.
Granite Recovery Center is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.
DSNP Utilization Management Nurse
Utilization review nurse job in Somerville, MA
Site: Mass General Brigham Health Plan Holding Company, 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
The D-SNP UM Case Manager, RN performs utilization management activities primarily for D-SNP (OneCare and Senior Care Options), including review of integrated organization determinations for outpatient, inpatient, post-acute, and long-term services and supports (LTSS) following CMS and EOHHS regulations.
Qualifications
Education
Associate's Degree Nursing required; Bachelor's Degree Nursing preferred
Licenses and Credentials
Massachusetts Registered Nurse license required
Basic Life Support [BLS Certification] Certification preferred
Experience
At least 2-3 years of utilization management strongly preferred
Experience applying National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and LTSS guidelines highly preferred
InterQual experience preferred
Knowledge, Skills, and Abilities
Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Ability to establish strong rapport and relationships with patients and staff.
Proficient in Microsoft Office and industry related software programs.
Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
Ability to maintain client and staff confidentiality.
Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care.
Knowledge of Healthcare and Managed Care preferred.
Additional Job Details (if applicable)
Working Conditions
This is a remote role that can be done from most US states
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$58,656.00 - $142,448.80/Annual
Grade
98TEMP
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:
Mass General Brigham Health Plan Holding Company, 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.
Auto-ApplyUtilization Review RN
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.
Auto-ApplyUtilization Management Nurse
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 *************************************************************
Easy ApplyUtilization Review Nurse
Utilization review nurse job in Providence, RI
· Participates in the development and ongoing implementation of QM Work Plan activities. · Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives Responsibilities: · Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.
· Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.
· Data gathering requires navigation through multiple system applications.
· Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information.
· Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines.
· Responsible for the review and evaluation of clinical information and documentation.
· Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
· Works Potential Quality of Care cases across all lines of business (Commercial and Medicare).
· Independently coordinates the clinical resolution with internal/external clinician support as required.
· Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data
· Prepares and completes QM documents based on interpretation and application of business requirements
· Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements
· Assists in the development and implementation of QM projects and activities
· Accountable for completing and implementation of QM Work Plan Activities
Experience:
· 3+ years of experience as an RN
· 1+ years of inpatient hospital experience
· Registered Nurse in state of residence
· Must have prior authorization utilization experience
· Able to work in multiple IT platforms/systems
Skills:
· MUST HAVE MEDCOMPASS or ASSURECARE exp.
· MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.
· MUST HAVE UM experience, inpatient utilization management review.
· MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG.
· MUST HAVE 6 months of Prior Authorization.
Education:
· Active and unrestricted RN licensure in state of residence
**About US Tech Solutions:**
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (*********************************** .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Concurrent Review Nurse
Utilization review nurse job in Bedford, NH
Discharge planning.
Educate providers on utilization and medical management.
Provide clinical knowledge.
Perform onsite review of emergent/urgent and continued stay requests
Qualifications
2+ years of clinical nursing experience in an acute care.
Current state's RN license.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Behavioral Health Community Partnership (BHCP) Nurse Case Manager
Utilization review nurse job in Boston, MA
Behavioral Health Community Partnership (BHCP) Nurse Case Manager Department: Social Services Supervisor: Director of Nursing Status/Hours Per Week: Non-exempt / 35 hours Pay Range: The expected base pay for the position is $36-$65.02 per hour and may be increased based on other factors, such as language, certifications, etc.
Primary Function:
The Behavioral Health Community Partnership Nurse Case Manager [BHCP RN Case Manager] functions under the supervision of the Director of Nursing and overall guidance and consultation with the Medical Director and other Primary Care Providers to conduct patient monitoring, tracking, and provide ongoing care coordination and support to patients with behavioral health issues that are enrolled in BHCP. The BHCP RN Case Manager ensures patients' adequate linkages with behavioral health counseling, all levels of substance use care, including medication assisted treatment, and chronic pain management care.
Duties & Responsibilities:
* Receive and maintain a log of all patients enrolled in BHCP, and ensure adequate follow up and care coordination.
* Serve as Clinical Care Manager for enrollees referred to the team, participating in the assessment, care planning, and on-going BHCP service provision specified in program protocols and policies.
* Review and approve Comprehensive Health Assessments for members including performing medication reconciliations.
* Make patient referrals to behavioral health, and human services providers at the Health Center for needed services such as primary care and other substance use and mental health care.
* Make "warm handoffs" and coordinate support to needed services at external organizations including hospitals, substance use treatment programs, etc.
* Follow up with members post-discharge to ensure members are seen by a Primary Care provider in a timely manner.
* Monitor and track patients including progress in their treatment plan and update PCPs and other members of the team.
* Participate in multi-disciplinary team meetings, utilization review, and program planning.
* Participate in consultation, sharing of resources and best practices with other Riverside Community Partner teams.
Utilization Management Coordinator, SBH
Utilization review nurse job in Framingham, MA
Summary: SMOC Behavioral Healthcare is a division of SMOC that provides substance abuse and mental health outpatient services to individuals, children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. Candidates must possess at least 2-3 years' experience billing 3
rd
party insurance, work with Department of Public Health contracts.
Why Work for SMOC?
Paid Time Off: All full-time employees can accrue up to 3 weeks of vacation, and 2 weeks of sick time and are eligible for 12 paid holidays during their first year of employment.
Employer-paid Life Insurance & AD&D and Long-Term Disability for full-time employees.
Comprehensive Benefits Package including Medical Plans through Mass General Brigham with an HRA Employer cost-sharing program, Dental Plans with Orthodontic Coverage, and EyeMed Vision Insurance available to full-time employees.
403(B) Retirement Plan with a company match starting on day one for all full-time and part-time employees.
Additional voluntary benefits including; Term and Whole Life Insurance, Accident Insurance, Critical Illness, Hospital indemnity, and Short-Term Disability.
Flexible Spending Accounts, Dependent Care Accounts, Employee Assistance Program, Tuition Reimbursement and more.
Primary Responsibilities:
Interface with the billing subcontractor. Work hand in hand with representatives from the billing contractor and the clinic front office to make adjustments in the health record to ensure all activities are billable to all payors.
Ensure all client payor information and authorizations are entered into the electronic health record.
Reconcile and resolve issues related to claims submissions, research and resolve eligibility issues, including contact with clients to inform of eligibility loss.
Ensure all new and ongoing prior authorizations are entered for the Outpatient Clinic programs, Residential Recovery Programs.
Ensure all billing to Department of Public Health is entered accurately and in a timely fashion, for the RRS and outpatient clinic programs.
Review denials and partially paid claims and resolve discrepancies.
Assist in resolving overdue claim problems.
Run reports and gather data as needed for financial and operating reports.
Recommend write-off and process in billing system as directed.
Ensure compliance with program/department, agency and/or funder requirements, as well as, SMOC policies & procedures.
Other duties as assigned.
Knowledge and Skill Requirements:
Associates Degree preferred or relevant experience
Medical and/or Mental Health third party billing experience
Experience with third party billing denial and resolution process
Must have ability to handle multiple and changing priorities and meet deadlines
Organizational Relationship: Directly reports to Operations Director. Indirectly reports to Director of Residential Recovery Programs. Direct reports of this position are none.
Physical Requirement:
Ability to ascend and descend stairs
Ability to see and read
Ability to lift up to 10lbs
Dress is business casual
Working Conditions: As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or incidental contact with clients served by SMOC in various programs funded or administered through the Executive Office of Health and Human Services.
Remote Work Option: Remote work is permissible in some positions at SMOC depending on the key functions and responsibilities. The Compliance Officer position is eligible to work from home 0-60% of the week in scheduling coordination with the department manager.
Monday through Friday: 9:00AM - 5:00PM. Includes a 1-hour unpaid lunch break.
35 Hours per week.
Auto-ApplyClinical Nurse Liaison
Utilization review nurse job in Dedham, MA
Clinical Nurse Liaison
Title of Immediate Supervisor: Senior Director, Home and Community-Based Services
The Liaison enhances continuity of patient care by providing liaison between assigned locations (SNFs, ALs and other), physicians, and home care agency.
Position Responsibilities Include:
Transfers Patients from facility to HCBS service lines that include home health and hospice services by establishing and maintaining relationships with nurses, social services, physical and occupational therapy, and other support services.
Provides all necessary information concerning home care/hospice intake coordination and provides input related to clinical concerns for individual patients.
Resolves patient care issues by working one-on-one with Patient Care Managers to standardize patient home care assessments; collecting relevant information; conferring with co-care givers; assessing patient home care needs.
Keeps facility and attending physician informed of patient status by monitoring and reporting home care services rendered and/or modified; following up on patient reports and other patient information; anticipates additional home care services needed, i.e. wound therapy, physical therapy, social work and/or other specialties.
Promotes effective written/verbal communication daily.
Gives accurate information to patients and or families regarding home care and related issues.
Serves and protects home care/hospice by adhering to professional standards, policies and procedures, federal, state, and local requirements, and professional and licensing standards.
Promotes education for patients, their families and the community.
Assists in intake process by entering as much documentation as possible regarding patients transfer to home care/hospice
Updates job knowledge by participating in educational opportunities.
Keeps an accurate log of all discharges to home care from facility and submits completed log on monthly basis.
Serves as a resource and support to patients.
Identifies and responds to safety concerns of patients.
Maintains compliance with policies, procedures, and regulatory matters.
Promotes and maintains an agency environment that is in compliance with federal, state, and local regulatory agencies.
Participates in personal and professional growth and development including staff meetings and in-service education.
Communicates with patients, families, and other health professionals in a manner that conveys respect, caring, and sensitivity.
Communicates with the physician and/or nurse practitioner regarding patient status and medical intervention.
Contributes to HCBS program effectiveness by identifying short-term and long-range issues that must be addressed; providing information and commentary pertinent to deliberations; recommending options and courses of action; implementing directives
Enhances HCBS service reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
Provides information by responding to queries of hospitals, nursing homes, attending physicians and their practice staffs, and other agencies; sorting and distributing messages and documents; answering questions and requests; preparing information for patient transfer; preparing statistical reports related to referral and intake activities from assigned locations maintaining databases.
Educates assigned location teams by attending team and community meetings; providing orientation/in-service programs concerning home care intake coordination and hospital relations; providing input relating to clinical concerns for individual patients.
Reflects the cultural Belief of Teaming Up with HSL peers including Intake Coordinators to optimize patient transitions.
Performs other duties and activities as delegated by the Supervisor and the Executive Director.
Markets HCBS services to HSL housing sites, hospitals, physician groups, ALFs, senior centers and at vendor fairs.
Performs patients screens at the request of referral sources
Attends networking events as requested
Qualifications:
Graduate of an Accredited School of Nursing.
Current License with Massachusetts State Board of Nursing.
Two years nursing experience preferred.
Good verbal and written communication skills.
Must be motivated to learn and flexible to change.
Computer literacy required.
Must be able to work independently.
Current CPR certification.
Remote Type
Hybrid
Hebrew SeniorLife is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Auto-ApplyNurse Coordinator (PHN-10)
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.
Wellness Nurse Per Diem
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.
Ambulatory Pulmonary Nurse
Utilization review nurse job in East Providence, RI
Job Description
Provides nursing care for pulmonary patients in the ambulatory setting -primarily via telephone and secure messaging, rather than through direct patient contact. The nurse is an integral member of the pulmonary care team in helping patients achieve optimal lung health and in managing chronic conditions effectively - through assessment, planning, treatment and evaluation/re-evaluation. Provides safe, knowledgeable, compassionate, individualized and goal-directed nursing care to patients of the division of Pulmonary, Critical Care & Sleep Medicine at Brown Medicine.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Consistently applies the Brown Medicine values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Medicine mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Medicine Compliance Program and Code of Conduct.
Consistently practices the Brown Medicine Customer Service Standards.
Provide nursing triage, assessment and education to patients via nurse visits, telephone interactions and secure messaging
Manage patient needs including medication management, post procedure instructions and care coordination.
Serve as a liaison to patients, family members and referring providers with guidance from pulmonary providers.
Acts as patient advocate in the coordination of patient care.
Demonstrates understanding and interpretation of diagnostic measures such as lab tests.
Identifies goals for the individual patient and communicates these goals to the appropriate care team member involved in the patient's care.
Reports and documents information accurately and in a timely manner
Seeks guidance, direction and assistance where needed.
Adheres to BMED Policy and Procedures at all times and is an active participant in the QI program
Adheres to required infection prevention measures and environmental safety practices.
Participates in staff meetings and In-services as required/requested.
Demonstrates flexibility in patient care, assignment, schedule.
Delegate tasks and direct the activities of unlicensed care providers (schedulers, Medical Assistants and Staff Assistants).
Utilizing supplies, equipment and resources to contains costs without compromising delivery of care
Performs other duties as assigned
KNOWLEDGE, SKILLS & ABILITIES REQUIRED:
Good command of the English language, both verbal and written. Equivalent mastery of the Spanish language is preferred but not required.
Ability to work well with physicians, APPs, employees, patients, families and others.
Pulmonary, Nurse Triaging, and/or Ambulatory experience required.
EDUCATION AND EXPERIENCE
Graduate of a Professional School of Nursing
Current state licensure as a registered nurse (RN) or licensed practical nurse (LPN)
Current certification in BLS
Evidence of continuing education
WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation(s) may be made to enable individuals with disabilities to perform the essential functions.
May have exposure to patients with communicable diseases, blood and body fluids
May have exposure to hazardous equipment/gases/chemical agents
INDEPENDENT ACTION:
Ability to act independently without direct supervision.
SUPERVISORY RESPONSIBILITY:
None.
Reports to:
Pulmonary Medical Director/Physician Lead & Practice Manager
Employees are required to be vaccinated against Covid as a condition of employment, subject to accommodation for medical exemptions.
We value a diverse, talented workplace and seek colleagues who strive to better understand systemic barriers as it affects patient care and our academic institutions. Brown Medicine welcomes nominations and applications from all individuals with varied experiences, perspectives, abilities, identities, and backgrounds to enrich our clinical, research, training and service missions.
Wellness Nurse (LPN) Sign On Bonus
Utilization review nurse job in Beverly, MA
The Current Beverly, our senior living community in Beverly, MA is a beautiful newly renovated historic building, inviting residents for both Assisted Living and Memory Care. Apply now for consideration and/or to learn more!
Each and every member of our team is committed to developing progressive yet approachable communities to support the needs of all future generations. We want to transform healthcare infrastructure so that people can not only age well but live well and THRIVE.
Job Description
Reporting to Director of Health and Wellness, the Wellness Nurse (LPN) provides direct nursing care to the residents, and supervises the day-to-day nursing activities performed by care staff.
Schedule: The Wellness Nurse (LPN) is Full-Time: 7am - 3pm and/or 7:30am-7:pm. We also have Part-Time and Per diem available for all shifts
Salary Range: $37.00 - $41.00 Hourly
Responsibilities and Duties
Supervise care staff in accordance with current state regulations and community policies
Monitors the health, safety, and well-being of all residents
Assisting in training and monitoring of medication administration
Maintaining clinical quality assurance in accordance with federal, state and local standards
Promote the highest degree of service to our residents while leading and demonstrating the mission of the company
Conduct thorough resident assessments
Qualifications
Graduation form an accredited School of Nursing, with current LPN license
At least 1 year of experience with long-term care, assisted living, home health or hospital setting preferred
Experience working with residents with Alzheimer's or other related dementias
Ability to handle multiple tasks
Knowledge of federal and state regulations, and of nursing practices, techniques and methods applied to health and wellness resident
Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications
While performing the duties of this job, the associate is often required to stand, walk, sit, use fine and gross motor skills, reach with hands and arms, balance, stoop, kneel, crouch, talk, hear, and smell.
An individual in this position will be required to lift or carry weight in up to 50 lbs. Intermittent physical activity includes lifting and supporting residents. The associate must use proper body mechanics.
Additional Information
Benefits Offered(Full Time):
Health Insurance: Medical/Rx, Dental, and Vision
Ancillary Benefits: Life Insurance/AD&D, Short Term Disability and Long-Term disability
Basic Life & Accidental Death & Dismemberment (AD&D) Insurance
FSA (Commuter/Parking)
Employee Assistance Program (EAP)
401(k) Retirement with Company Match
Paid Time Off (PTO) and Holidays
Tuition Reimbursement
Other Compensation Programs:
Employee Referral Bonus
Resident Referral Bonus
Benefits Offered (for Part-Time Employees):
Paid Time Off (PTO) and Holidays
Flexible Schedule
On the job training
Employee Assistance Program (EAP)
Free Parking
Other Compensation Programs:
Employee Referral Bonus
Resident Referral Bonus
Benefits Offered (Per Diem Employees):
Flexible Schedule
On the job training
Free Parking
Equal Opportunity Statement:
Monarch Communities and Brandywine Senior Living is an Equal Opportunity Employer.
We comply with all applicable federal, state, and local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Day Camp Nurse - Camp Ponkapoag (Canton)
Utilization review nurse job in Canton, MA
Job DescriptionDescriptionCamp Ponkapoag - YMCA of Greater Boston Seasonal - Summer 2025 Are you a compassionate, energetic nurse looking for a rewarding summer experience? Join us at Camp Ponkapoag, nestled in the scenic Blue Hills Reservation, just minutes from downtown Canton. We're seeking a dedicated Day Camp Nurse to help keep our campers and staff safe, healthy, and thriving all summer long.
This is a fantastic opportunity for school nurses, pediatric professionals, or any nurse who enjoys working with children in a dynamic, outdoor environment.
Key Responsibilities
Prioritize the health, safety, and emotional well-being of all campers and staff.
Maintain daily health logs and accurate medical records for all camp participants.
Dispense medications according to prescribed schedules and maintain secure storage.
Prepare and audit first aid medical bags for supplies and correct emergency medications.
Administer first aid and respond to minor medical needs on-site.
Assess health concerns and determine when to escalate care or involve emergency services.
Communicate effectively with parents, caregivers, and camp staff regarding health concerns.
Liaise with local healthcare providers as needed.
Stay informed of camper medical needs (e.g., allergies, special diets) and educate staff as needed.
Accompany campers or staff to hospitals when necessary.
Participate in camp activities and events to stay engaged and connected with the camp community.
Serve as a positive role model, reflecting YMCA values and camp spirit at all times.
Skills, Knowledge and ExpertiseQualifications
Licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the state of Massachusetts (or willing to obtain licensure).
Experience in pediatrics, emergency medicine, or school nursing preferred.
CPR/First Aid Certification (or willingness to obtain prior to camp start date).
Strong communication and interpersonal skills.
Ability to work independently and make sound decisions under pressure.
Previous experience working with children (not necessarily in a medical role).
Additional Qualities
Friendly, approachable, and calm under pressure.
Adaptable to the unique rhythm of camp life.
A team player who's excited to contribute to a positive, community-centered environment.
BenefitsMake a difference this summer-join the Camp Ponkapoag team and help create a safe, healthy, and unforgettable experience for our campers!
Per Diem Dispensing Nurse
Utilization review nurse job in Chelsea, MA
*Per Diem Dispensing Nurse - LPN/LVN* * *Health Care Resource Centers *is looking for a detail oriented and empathetic Licensed Practical Nurse / Licensed Vocational Nurse to dispense prescribed medications as part of a treatment team in partnership with Physicians and Nursing Supervisors. The dispensing nurse also shares responsibility of maintaining dispensing equipment, managing medication inventory and reporting patient treatment information.
An ideal dispensing nurse candidate works cooperatively with supervisory counseling staff and demonstrates a non-judgmental and accepting attitude toward the Substance Use Disorder.
*Responsibilities: *
* Administer daily medication to patients in accordance with program policy and medical protocols. *
* Use automated dispensing system(s), calibrate pump and maintain dispensing equipment
* Produce and maintain appropriate records and reports as required by Company protocol, Federal and State Regulations
* Ensure compliance with security standards for the distribution and storage of controlled substances as set forth in the Code of Federal regulations
* Order, receive and stock medication in accordance with DEA and State regulations. (If granted Power of Attorney)
* Provide daily assessment of patients
* Assist Nursing Supervisor to orient new nursing staff
* Other related duties as determined by supervisor
*Qualifications: *
* Current & good standing LPN/LVN license in the State of Massachusetts
* Current CPR certification required
* EMR & computer proficiency desired
* Experience in chemical dependency preferred, self-motivated and directed, must have a positive attitude toward individuals in substance abuse treatment.
* Satisfactory drug screen and criminal background check.
*Salary Range: *
Salary ranges from $35.00 to $38.00 an hour.
The salary of the candidate(s) selected for this role will be set based on a variety of factors, including but not limited to, experience, education, specialty, and training.*
*Qualified Per Diem Employees receive:*
* 401K Retirement Plan
* Accrued Sick Time
* Employee Referral Program
* BayMark Perks Program
* BayMark University Learning
*
*Here is what you can expect from us:*
*
*Health Care Resource Centers*, a progressive substance abuse treatment organization, is committed to the highest quality of patient care in a comfortable outpatient clinic setting. Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.
*Health Care Resource Centers* is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.* *
* *
Utilization Management Nurse
Utilization review nurse job in Providence, RI
**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 *************************************************************
Easy ApplyConcurrent Review Nurse
Utilization review nurse job in Bedford, NH
Discharge planning. Educate providers on utilization and medical management. Provide clinical knowledge. Perform onsite review of emergent/urgent and continued stay requests Qualifications 2+ years of clinical nursing experience in an acute care. Current state's RN license.
Additional Information
All your information will be kept confidential according to EEO guidelines.
ED Nurse - Nights Part-Time - Faulkner
Utilization review nurse job in Plainville, MA
Site: Brigham and Women's Faulkner Hospital, 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.
Schedule: 24 hour night position 7p-7:30a every other weekend and rotating holidays.
Job Summary
In the ED, you will provide immediate acute care to our patients. You will triage, assess, treat and document care. We have 29 beds in our ED. Xrays, CTs, and ultrasounds are available 24 hours a day and MRIs most of the day. We are also a Primary Stroke Center.
The Registered Nurse is a professional nurse registered in Massachusetts who is responsible and accountable for planning and providing patient care for assigned patients in accordance with Nursing Standards of Care as set forth in the Nursing Department's Clinical Practice Manual. The registered nurse demonstrates initiative, knowledge and clinical skills in caring for the patient with complex needs. The Registered Nurse demonstrates the ability to effectively manage patients by assuming full responsibility for the assessment, plan, implementation and evaluation of patient care and is directly responsible to a designated nurse manager, or supervisor. The Staff Nurse will also assure the practice of the Patient and Family Centered Care Model in an environment that exemplifies best practice.
Qualifications
BSN required
Massachusetts Registered Nurse Licensure required
BLS Certification for Healthcare Providers required
Must obtain ACLS prior to end of orientation and may not practice independently without ACLS
PALS preferred
ED experience is strongly preferred
2 years' telemetry experience preferred
Good interpersonal and communication skills
Show evidence of the basic analytic thinking necessary to care for a group of patients
Ability to demonstrate observational skills and the ability to set priorities
Ability to adhere to all I.C.A.R.E. standards
Additional Job Details (if applicable)
Remote Type
Onsite
Work Location
1153 Centre Street
Scheduled Weekly Hours
24
Employee Type
Regular
Work Shift
Night (United States of America)
Pay Range
$41.36 - $100.00/Hourly
Grade
RN3500
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:
Brigham and Women's Faulkner Hospital, 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.
Auto-ApplyWellness Nurse Part Time 3-11
Utilization review nurse job in Weymouth Town, MA
Our mission is contemporary person-centric wellness senior living, designed for the next generation. A customized, curated, and organic approach to wellness inspires everything we do. All members of our communities - residents, their family members, and team members - help make our communities what they are.
Each and every member of our team is committed to developing progressive yet approachable communities to support the needs of all future generations. We want to transform healthcare infrastructure so that people can not only age well but live well and THRIVE.
The Current South Shore offers 91 independent living apartments, 48 assisted living apartments, and 26 memory care apartments, with a neighborhood atmosphere and maintenance-free lifestyle. It's located near South Shore Hospital and directly across from the South Weymouth Train Station, offering easy access for team members, and residents' families and friends.
Job Description
Reporting to the Director of Health and Wellness, the Wellness Nurse provides direct nursing care to the residents, and supervises the day-to-day nursing activities performed by care staff. Every other weekend availability required.
Salary Range: $38.00 - $42.00 Hourly
Responsibilities and Duties
Supervise care staff in accordance with current state regulations and community policies
Monitors the health, safety, and well-being of all residents
Assisting in training and monitoring of medication administration
Maintaining clinical quality assurance in accordance with federal, state and local standards
Promote the highest degree of service to our residents while leading and demonstrating the mission of the company
Conduct thorough resident assessments
Qualifications
Graduation from an accredited School of Nursing, with current LPN license
At least 1 year of experience with long-term care, assisted living, home health or hospital setting preferred
Experience working with residents with Alzheimer's or other related dementias
Ability to handle multiple tasks
Knowledge of federal and state regulations, and of nursing practices, techniques and methods applied to health and wellness resident
Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications
While performing the duties of this job, the associate is often required to stand, walk, sit, use fine and gross motor skills, reach with hands and arms, balance, stoop, kneel, crouch, talk, hear, and smell.
An individual in this position will be required to lift or carry weight in up to 50 lbs. Intermittent physical activity includes lifting and supporting residents. The associate must use proper body mechanics.
Additional Information
Valuing a connection to the community, we are creating a pedestrian-friendly front plaza which will offer art fairs, farmers markets, and festivals. Monarch believes its buildings serve residents, their families, and the Monarch team members. Therefore, they have created a team member and resident co-working space; art, creative, and performance spaces; and the WELL center (fitness, yoga, spa, and a fully-stocked juice bar) which can be used by all. Free meals during shift.
Benefits Offered (for Part-Time Employees):
· Paid Time Off (PTO) and Holidays
· Flexible Schedule
· On the job training
· Employee Assistance Program (EAP)
· Free Parking
Other Compensation Programs:
· Employee Referral Bonus
· Resident Referral Bonus
Equal Opportunity Statement:
Monarch Communities and Brandywine Senior Living is an Equal Opportunity Employer.
We comply with all applicable federal, state, and local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.