NewClinical Assessor, Registered Nurse - (Hybrid Remote-Boston, MA) Maximus IncClinical Assessor, Registered Nurse - (Hybrid Remote-Boston, MA)Boston, MARemoteIn this field-based role, you'll conduct comprehensive in-person assessments in members' homes, hospitals, and other community settings, evaluate medical, functional, behavioral health, and social needs, develop person-centered service plans, and collaborate with healthcare providers and community partners to coordinate care. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Team Nurse - Hybrid Remote Lahey Hospital and Medical CenterTeam Nurse - Hybrid RemoteCambridge, MARemote$32.24–$55.32 / hourTriages telephone inquiries, reviews lab results and diagnosis testing, and assures written patient notification of test results, missed appointments, and abnormal study follow-up when appropriate. Knowledge of nursing process, theories, and clinical expertise related to patient care, normally acquired through the completion of a nursing training program at an NLN accredited school of nursing.
Director, Healthcare Services (RN) (Remote in Massachusetts) Molina Healthcare IncDirector, Healthcare Services (RN) (Remote in Massachusetts)Waltham, MARemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
Manager- Healthcare Consulting TAG EisnerAmper, LLC (Inactive)Manager- Healthcare ConsultingBoston, MARemoteAbout our Healthcare Sector Services Group: The Health Care Consulting Group provides tailored services to a wide range of clients: hospitals and health systems, academic medical centers, physician and ancillary services practices, entrepreneurs and PE Firms, managed care entities and government agencies. Partner with IT, informatics, and operational leaders to design and implement workflow, configuration, and governance improvements (including change management and training) aligned to regulatory expectations and leading practices (e.g., CMS SAFER Guides).
Senior Manager, Clinical Study Quality Lead (Hybrid) Vertex PharmaceuticalsSenior Manager, Clinical Study Quality Lead (Hybrid)Boston, MassachusettsRemoteThe Senior Manager, Clinical Study Quality Lead provides study-level quality oversight for assigned clinical trials to help ensure they are conducted in compliance with Good Clinical Practice (GCP), applicable global regulations, study protocols, and Vertex procedures. This is an individual contributor role focused on GCP quality assurance oversight for clinical trials, including risk-based audit strategy, quality risk identification, issue escalation, CAPA support, compliance trend analysis, and inspection readiness.
NewSenior Healthcare Network Consultant Humana IncSenior Healthcare Network ConsultantMARemote$78,400–$107,800 / yearWork 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 required; wireless, wired cable or DSL connection is suggested. To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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.
NewLead Software Engineer - Remote or Hybrid in MN and DC UnitedHealth Group IncLead Software Engineer - Remote or Hybrid in MN and DCBoston, MARemote$112,700–$193,200 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. We have received recent reports of fraudulent LinkedIn messages and emails alleging or claiming to be sent from UnitedHealth Group, UnitedHealthcare, or Optum Executives.
Group Leader - Senior Director, Quantitative Pharmacology and Pharmacometrics (Hybrid or Remote) Merck & Co IncGroup Leader - Senior Director, Quantitative Pharmacology and Pharmacometrics (Hybrid or Remote)Boston, MARemote$210,400–$331,100 / yearReporting directly to the QP2 CMD Head and serving as their delegate when needed, the individual will collaborate closely with the QP2 CMD leadership team and broader organization to ensure consistent, high-value quantitative pharmacology contributions throughout the CMD portfolio from discovery through life cycle management. Senior Directors are recognized as scientific thought leaders that develop and implement translational PK/PD strategies, characterize clinical pharmacokinetics and pharmacodynamics, and shape regulatory strategy, dose selection and go/no-go decisions.
Customer Care L3 - Medical Imaging - Hybrid PaxeraHealthCustomer Care L3 - Medical Imaging - HybridNewton, MassachusettsRemoteTheir unique mix of skills and qualifications matches our customers’ needs, to ensure the delivery of great, purpose-built, customized software applications for healthcare providers – now and for the future. Our entire team shares a passion for exploring new ideas, overcoming challenges as well as designing, creating, and delivering market-leading health IT solutions and services.
NewSenior Manager, Technology Product Management - Technology & Cyber Governance - Remote or Hybrid in MN or DC UnitedHealth Group IncSenior Manager, Technology Product Management - Technology & Cyber Governance - Remote or Hybrid in MN or DCBoston, MARemote$112,700–$193,200 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. As part of governance, collaborate with Technology and Cybersecurity teams to ensure they define Key Risk Indicators (KRIs), Key Control Indicators (KCIs), and performance metrics, including thresholds aligned to risk appetite that support the GRC metrics framework.
Patient Navigator - BILH Weight Management Program ( On-Site / Hybrid / Remote ) Lahey Hospital and Medical CenterPatient Navigator - BILH Weight Management Program ( On-Site / Hybrid / Remote )Westwood, MARemote$26–$34.99 / hourJob Description: Primary Responsibilities: Performs direct outreach to patients to initiate patient engagement and enrollment with the clinic and perform introduction of the clinic, schedule initial appointment with clinician, and if necessary, follow-up assistance. The Patient Navigator supports the care of our patients in accessing and aintaining continuity with the healthcare team and assist patients in achieving their health care goals.
PROGRAM MANAGER - HYBRID Quality Improvement and Educational Programs School of Medicine Continuing Medicine Boston UniversityPROGRAM MANAGER - HYBRID Quality Improvement and Educational Programs School of Medicine Continuing MedicineBoston, MARemoteThe Program Manager, Quality Improvement and Educational Programs manage quality improvement (QI) projects on behalf of Boston University Center for Continuing Education (BU CCE) at the Chobanian & Avedisian School of Medicine and Boston Medical Center (BMC). Boston University Chobanian & Avedisian Center for Continuing Education produces high quality, unbiased continuing education activities based on valid content and best-evidence for a national audience of practicing healthcare clinicians.
Lead/Staff Full Stack Engineer, AI Platform & Agents (US/Canada Hybrid/Remote) Wolters Kluwer N.V.Lead/Staff Full Stack Engineer, AI Platform & Agents (US/Canada Hybrid/Remote)MARemoteStrong full‑stack development skills and cloud experience (AWS/Azure/GCP).Expert in at least one, and proficient across the others:AI Agent development and evaluationBackend developmentFrontend developmentCloud services (AWS/Azure/GCP)CI/CD and Infrastructure as CodeSite Reliability Engineering (SRE)Quality engineering / testing strategySecure SDLC and privacy by designProven track record delivering secure, reliable, cloud‑native systems to production. TypeScript, Node.js, React, Python, LangChain/LangGraph, MCP/A2A, RustAWS (primary), Azure, GCP; Docker, Terraform, GitHub ActionsDocumentDB, DynamoDB, OpenSearch, Azure AI SearchAzure OpenAI, AWS Anthropic, Google GeminiGitHub, Confluence, SlackWhat you'll doDesign and implement full‑stack applications, AI agents, and platform components that enable rapid GenAI agent development, validation, and deployment.
Intake Associate | Hybrid/Remote Schedule Beth Israel Lahey HealthIntake Associate | Hybrid/Remote ScheduleWoburn, MassachusettsRemoteThis role assists in various administrative clerical functions and in the processing of demographics for EMR charts, active patient orders and communication with other departments regarding patient status changes/updates. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.
Medical Records Manager | Home Health | Hybrid/Remote Lahey Hospital and Medical CenterMedical Records Manager | Home Health | Hybrid/RemoteWatertown, MARemote$66,560–$89,856 / yearActual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Essential Duties & Responsibilities including but not limited to: Works with the Director of Business Operations to provide direction and oversight to the functions related to the flow of orders and medical record processes.
Faculty - Director of Clinical Education - Hybrid Doctor of Physical Therapy Program Massachusetts College of Pharmacy and Health SciencesFaculty - Director of Clinical Education - Hybrid Doctor of Physical Therapy ProgramBoston, MARemoteThe Director of Clinical Education serves as the primary liaison between the program and clinical education partners and is responsible for the development, implementation, assessment, and continuous improvement of the clinical education program. The position requires expertise in physical therapist practice, clinical education, student mentoring, and management of clinical education processes within a hybrid learning environment.
Clinical & Translational Research Innovation Analyst III - Remote or Hybrid Lowell General HospitalClinical & Translational Research Innovation Analyst III - Remote or HybridBoston, MARemote$84,300.22–$107,481.20 / yearIn addition, this role focuses on performing the following Software Product Development duties: Designs, tests, and develops software products (end user applications, systems software, mobile/web applications, database products, etc.); Conducts requirements analysis and high-level design/modeling to convert external customer needs into software solutions; designs and specifies the overall software structure, core elements, and properties by analyzing the software requirements, constraints, interfaces, and dependencies. Examples of day to day tasks include: extract and manage data from institutional data warehouses; develop, maintain and document high quality reusable queries, and pipelines; translate complex research questions into structured data requests and analytic workflows; collaborate with CTSI informatics, and research teams to support grant-funded and investigator-initiated studies; contribute to data governance and quality assurance processes that ensure regulatory compliance; and facilitate process improvement initiatives.
Benign Gynecologist, Menopause focus, Hybrid Remote Lahey Hospital and Medical CenterBenign Gynecologist, Menopause focus, Hybrid RemoteBurlington, MARemote$350,000–$450,000 / yearp> Back to all jobs Benign Gynecologist, Menopause focus, Hybrid RemoteSave | Share | Copied!Apply now | Copy linkLocation: Burlington, MA Organization: Lahey Hospital and Medical Center Type: Full-time • Day When you join the growing BILH team, youre not just taking a job, youre making a difference in peoples lives. Pay Range: $350,000.00 USD - $450,000.00 USD The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time.
Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseRIRemote$71,100–$97,800 / yearWork-at-Home Information: 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 required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Clinical Reviewer Outpatient Registered Nurse # 26-10731 US Tech Solutions, Inc.Clinical Reviewer Outpatient Registered Nurse # 26-10731Canton, MARemote$50–$50 / hourKey Responsibilities/Duties – what you will be doing:Provides all aspects of clinical decision making and support needed to perform utilization management, medical necessity determinations and benefit determinations using applicable coverage documents, purchased clinical guidelines or Medical Necessity Guidelines for clinically complex services / coverage requests in a consistent manner and within established, product specific time frames. Interfaces between Precertification staff and providers when issues arise regarding policy interpretation, potential access availability or other quality assurance issues to ensure that members receive coverage decisions timely within all accrediting and regulatory guidelines.
Clinical Reviewer Utilization Management Registered Nurse # 26-07418 US Tech Solutions, Inc.Clinical Reviewer Utilization Management Registered Nurse # 26-07418Canton, MARemote$60–$61 / hourKey Responsibilities/Duties – what you will be doingProvides all aspects of clinical decision making and support needed to perform utilization management, medical necessity determinations and benefit determinations using applicable coverage documents, purchased clinical guidelines or Medical Necessity Guidelines for clinically complex services / coverage requests in a consistent manner and within established, product specific time frames. Interfaces between Precertification staff and providers when issues arise regarding policy interpretation, potential access availability or other quality assurance issues to ensure that members receive coverage decisions timely within all accrediting and regulatory guidelines.
Registered Nurse, Radiology - 36hrs Boston Children's HospitalRegistered Nurse, Radiology - 36hrsBoston, MARemote$76,003.20–$163,678.32 / yearPotential to rotating through the assessment role of chart review, patient phone assessment and patient care coordination prior to anxiolysis and anesthesia for a variety of Radiology imaging studies. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team.
Case Manager Registered Nurse (Remote, East Coast) CVS Health CorpCase Manager Registered Nurse (Remote, East Coast)MARemote$66,575–$142,576 / yearAssesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client's appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
NewRegistered Nurse, Clinical Delivery Care AccessRegistered Nurse, Clinical DeliveryBoston, MARemote$34–$48 / hourWith programs like Future of Medicine, which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers, which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Furthermore, they serve as a point of escalation for the Member Services team, addressing complex inquiries related to lab results and assisting in the resolution of patient concerns by providing clinical insights and ensuring patients receive accurate information and appropriate follow-up.
Case Manager, Registered Nurse - Fully Remote CVS Health CorpCase Manager, Registered Nurse - Fully RemoteRIRemote$54,095–$155,538 / yearBenefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
Nurse Practitioner, Compass Plus Program Brigham and Women's HospitalNurse Practitioner, Compass Plus ProgramSomerville, MARemote$126,838.40–$173,867.20 / yearThe program brings together providers, nurses, behavioral health specialists, and other care team members to deliver coordinated, patient-centered care focused on improving health outcomes, enhancing access to services, and supporting long-term health management. We are seeking a full-time, 40-hour Nurse Practitioner to join the Compass Plus team, caring for a panel of approximately 120 patients throughout the Northern Massachusetts region, including but not limited to Lawrence, Lowell, Peabody, and Newburyport.
Prior Authorization RN Humana IncPrior Authorization RNMARemote$71,100–$97,800 / yearThe 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 required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Nurse Practitioner, Compass Plus Program Mass General BrighamNurse Practitioner, Compass Plus ProgramSomerville, MassachusettsRemoteThe program brings together providers, nurses, behavioral health specialists, and other care team members to deliver coordinated, patient-centered care focused on improving health outcomes, enhancing access to services, and supporting long-term health management. We are seeking a full-time, 40-hour Nurse Practitioner to join the Compass Plus team, caring for a panel of approximately 120 patients throughout the Northern Massachusetts region, including but not limited to Lawrence, Lowell, Peabody, and Newburyport.
Manager, Care Management, RN CareforthManager, Care Management, RNBoston, MassachusettsRemote$89,160–$115,000 / yearFull timeWhat You Will Bring: Bachelor’s degree or equivalent work experience preferably in a health care or social services discipline is required along with 7+ years of case management experience in healthcare and social services, preferably with experience in eldercare, and/or people with disabilities or other complex medical needs . This person is responsible for directing care management operations and leading a team to deliver services that engage, motivate, and educate family caregivers to support complex individuals, keeping care at home.
Supervisor Nurse Educator Consulting Services Ascend Learning LLCSupervisor Nurse Educator Consulting ServicesMARemoteHeadquartered in Burlington, MA, with additional office locations and hybrid and remote workers in cities across the U.S., Ascend Learning was recognized by Newsweek and Plant-A Insights Group as one of Americas 2025 Greatest Workplaces as well as Americas Best Places to work for Mental Well-Being for 2025. As a Supervisor, Nurse Educator, Consulting Services, youll spearhead the creation and implement program management tools including curriculum accreditation and systematic evaluation plans, clinical site management, and program evaluation to enhance client outcomes.
Nurse Case Manager (West Region) Intellia Therapeutics IncNurse Case Manager (West Region)Cambridge, MARemote$193,500–$236,500 / yearThe Nurse Case Manager (NCM) is a licensed Registered Nurse and senior individual contributor responsible for providing high-touch, non-promotional clinical education, care coordination, and access support to patients, caregivers, and healthcare providers throughout therapy initiation and ongoing management. The salary offered is determined based on a range of factors including, but not limited to, relevant education and training, overall related experience, specialized, rare or in-demand skill sets, internal comparators and other business needs.
Nurse Case Manager (Southeast Region) Intellia Therapeutics IncNurse Case Manager (Southeast Region)Cambridge, MARemote$193,500–$236,500 / yearThe Nurse Case Manager (NCM) is a licensed Registered Nurse and senior individual contributor responsible for providing high-touch, non-promotional clinical education, care coordination, and access support to patients, caregivers, and healthcare providers throughout therapy initiation and ongoing management. The salary offered is determined based on a range of factors including, but not limited to, relevant education and training, overall related experience, specialized, rare or in-demand skill sets, internal comparators and other business needs.
Nurse Case Manager (Northeast Region) Intellia Therapeutics IncNurse Case Manager (Northeast Region)Cambridge, MARemote$193,500–$236,500 / yearThe Nurse Case Manager (NCM) is a licensed Registered Nurse and senior individual contributor responsible for providing high-touch, non-promotional clinical education, care coordination, and access support to patients, caregivers, and healthcare providers throughout therapy initiation and ongoing management. The salary offered is determined based on a range of factors including, but not limited to, relevant education and training, overall related experience, specialized, rare or in-demand skill sets, internal comparators and other business needs.
Nurse Case Manager (Central Region) Intellia Therapeutics IncNurse Case Manager (Central Region)Cambridge, MARemote$193,500–$236,500 / yearThe Nurse Case Manager (NCM) is a licensed Registered Nurse and senior individual contributor responsible for providing high-touch, non-promotional clinical education, care coordination, and access support to patients, caregivers, and healthcare providers throughout therapy initiation and ongoing management. The salary offered is determined based on a range of factors including, but not limited to, relevant education and training, overall related experience, specialized, rare or in-demand skill sets, internal comparators and other business needs.
RN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorBrookline, MassachusettsRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
NewAssistant/Associate Professor of Practice & Clinical Simulation Learning Specialist Simmons UniversityAssistant/Associate Professor of Practice & Clinical Simulation Learning SpecialistBoston, MARemote$85,196–$116,716 / yearInterested candidates should submit the following electronically with their application: (1) a letter of application addressing teaching experiences, (2) teaching philosophy, course or content interests, and clinical/professional interests and expertise; and (3) curriculum vitae. Simmons is committed to creating, developing, promoting, and enhancing inclusive hiring practices-at all levels, for all positions-ensuring diverse talent pools and the delivery of a consistent positive candidate experience.
Clinical Guide: Cardiology Nurse Devoted Health IncClinical Guide: Cardiology NurseWaltham, MARemote$80,000–$100,000 / yearThats why were gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Collaborating with an interdisciplinary team of registered nurses, advanced practice nurses, physicians, social workers, and pharmacists on shared members, to ensure were working together to meet the needs of the members.
Utilization Management Nurse Consultant (Weekend) CVS Health CorpUtilization Management Nurse Consultant (Weekend)Work At Home, RIRemote$29.10–$62.32 / hourEducation: Diploma RN acceptable; Associate degree/BSN preferred, 3+ years of experience as a Registered Nurse, 1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience. Position Summary: Utilize your clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members.
Clinical Documentation Integrity Specialist RN (MNA) UnitedHealth Group IncClinical Documentation Integrity Specialist RN (MNA)Auburndale, MARemote$38.66–$71.87 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. We"re an innovative health care leader and multi-specialty group practice, delivering an effective, connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts.
Clinical & Regulatory Manager - Dialysis Operations (RN) - Northeast Region (CT/MA/NY/RI) American Renal Associates Holdings IncClinical & Regulatory Manager - Dialysis Operations (RN) - Northeast Region (CT/MA/NY/RI)Boston, MARemoteThis data-driven role serves as the regional clinical subject matter expert by proactively identifying gaps in clinical practice and opportunities to improve patient outcomes, and escalating findings to appropriate corporate clinical and operational leaders to drive aligned, actionable improvements. Summary: The Clinical & Regulatory Manager (CRM) is an RN with dialysis expertise who leads clinical quality, regulatory compliance, and outcome improvement across clinics in Massachusetts, Rhode Island, Connecticut, New York.
Utilization Management Nurse Consultant CVS Health CorpUtilization Management Nurse ConsultantMARemote$29.10–$62.32 / hourCoordinate, monitor, and assess healthcare service options to help ensure Medicare Integrated/dually eligible members receive appropriate, cost-effective care. Utilizes clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program for Medicare Integrated/dually eligible member populations.
Care Manager, LTSS (RN) - (Remote in Boston, MA) Molina Healthcare IncCare Manager, LTSS (RN) - (Remote in Boston, MA)Boston, MARemoteAt least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorBoston, MARemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Bilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology Devoted Health IncBilingual (Spanish) Advanced Practice Provider (NP or PA): CardiologyWaltham, MARemoteAs part of the clinic you will also provide dedicated clinical services during part of your clinical time to our heart failure clinic which is a highly tailored, specialty center focused on providing best in class heart failure management including optimizing guideline directed medical therapy, providing health coaching, and managing volume overload. That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love.
Utilization Management Nurse Consultant - Fully Remote CVS Health CorpUtilization Management Nurse Consultant - Fully RemoteRIRemote$26.01–$74.78 / hourBenefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Urgent Care Nurse Practitioner Included Health IncUrgent Care Nurse PractitionerRIRemoteWe're seeking board certified Nurse Practitioners licensed in Rhode Island (multi licensed strongly preferred) with broad clinical expertise and a passion for improving healthcare access and quality. In this role, you'll deliver virtual comprehensive care to patients of all ages across a wide range of conditions, while working closely with our provider and support teams.