Clinical Nurse Specialist

3 weeks ago


Braintree, Massachusetts, United States El Paso Children's Hospital Full time
About the Position

The Clinical Nurse Specialist - Utilization Management will play a key role in ensuring that patients receive the necessary medical care while minimizing unnecessary costs. This position will be responsible for reviewing and authorizing medical treatments, procedures, and services to ensure that they are medically necessary and meet the standards of care.

Responsibilities
  • Review and authorize medical treatments, procedures, and services to ensure that they are medically necessary and meet the standards of care.
  • Collaborate with healthcare providers to ensure that patients receive the necessary medical care while minimizing unnecessary costs.
  • Develop and implement policies and procedures to ensure that utilization management practices are consistent with the organization's goals and objectives.
  • Provide education and training to healthcare providers on utilization management practices and policies.
  • Monitor and evaluate the effectiveness of utilization management practices and make recommendations for improvement.
Requirements
  • Current and unrestricted California Board Licensed Vocational Nurse (LVN) or Registered Nurse (RN) license.
  • 3 years of clinical nursing experience, preferably in a managed care environment.
  • 2 years of progressive leadership experience, including direct supervision of staff in managed care and/or utilization management.
  • 1 year of utilization management/prior authorization review experience.


  • Braintree, Massachusetts, United States Aspire Health Alliance Full time

    About Aspire Health AllianceAspire Health Alliance is a private, non-profit behavioral health agency providing services for children, teens, and adults experiencing serious emotional challenges, behavioral issues, and substance abuse. Our vision is there is no health without mental health.Job SummaryWe are seeking a skilled Clinical Care Specialist to join...


  • Braintree, Massachusetts, United States Aspire Health Alliance Full time

    Job Title: Clinical Care SpecialistAspire Health Alliance is seeking a skilled Clinical Care Specialist to join our multi-disciplinary team providing clinical care in the community to adults with mental health and substance use diagnoses.About the Role:Develop comprehensive clinical assessments, risk/safety planning, and treatment planning for clients.Lead...


  • Braintree, Massachusetts, United States Aspire Health Alliance Full time

    Exciting Opportunity at Aspire Health AllianceWe are seeking a skilled Clinical Care Specialist to join our multi-disciplinary team providing clinical care in the community to adults with mental health and substance use diagnoses.As a member of our team, you will gain comprehensive clinical experience working under experienced, independently licensed...


  • Braintree, Massachusetts, United States Jennie Stuart Health Full time

    Aspire Health Alliance: A Leader in Community Mental HealthWe are seeking a dedicated Clinical Recovery Specialist to join our Adult Community Clinical Services (ACCS) team. As a key member of our team, you will provide clinical assessment, risk/safety planning, and treatment planning for adults with serious mental illness.Key Responsibilities:Provide...


  • Braintree, Massachusetts, United States Jennie Stuart Health Full time

    About the RoleWe are seeking a dedicated Clinical Recovery Specialist to join our Adult Community Clinical Services (ACCS) team at Aspire Health Alliance. As a key member of our team, you will provide clinical assessment, risk/safety planning, and treatment planning for adults with serious mental illness.Key ResponsibilitiesProvide clinical leadership for an...


  • Braintree, Massachusetts, United States Incredible Health Full time

    Job Title: Clinical Research NurseIncredible Health is actively hiring a Clinical Research Nurse to join our team in the Long Branch, NJ area.Job Summary:We are seeking a highly skilled and experienced Clinical Research Nurse to coordinate and manage patient care in line with protocol requirements. The successful candidate will work closely with Principal...

  • Registered Nurse

    3 weeks ago


    Braintree, Massachusetts, United States Mass General Brigham Full time

    Job Title: Registered Nurse - Endoscopy SpecialistMass General Brigham is seeking a skilled Registered Nurse to join our Endoscopy team as an Endoscopy Specialist. This role will play a critical part in ensuring the smooth operation of our Endoscopy Center, providing exceptional patient care, and collaborating with our clinical team to deliver high-quality...

  • Registered Nurse

    2 weeks ago


    Braintree, Massachusetts, United States Mass General Brigham Full time

    Job Title: Registered Nurse - Endoscopy SpecialistMass General Brigham is seeking a highly skilled Registered Nurse to join our Endoscopy team as an Endoscopy Specialist. This role will play a critical part in ensuring the smooth operation of our Endoscopy Center, providing exceptional patient care, and contributing to the delivery of high-quality GI...


  • Braintree, Massachusetts, United States Mass General Brigham Full time

    Cardiology Nurse Specialist OpportunityWe are seeking a skilled Cardiology Nurse Specialist to join our team at Mass General Brigham. As a key member of our Cardiology Suite, you will be responsible for providing exceptional patient care and support to patients with cardiovascular conditions.Key Responsibilities:Provide phone triage and advice to patients in...


  • Braintree, Massachusetts, United States Mass General Brigham Healthcare at Home Full time

    About the RoleMass General Brigham Healthcare at Home is seeking a skilled Registered Nurse to join our team in a part-time capacity. As a member of our interdisciplinary team, you will provide high-quality clinical services to patients in various settings within the community.Key ResponsibilitiesDeliver quality, clinical services to patients in accordance...

  • Registered Nurse

    4 weeks ago


    Braintree, Massachusetts, United States Mass General Brigham Full time

    Job Title: Registered Nurse - Endoscopy SpecialistMass General Brigham is seeking a highly skilled Registered Nurse to join our Endoscopy team in Braintree, Massachusetts.Job Summary:We are looking for a dedicated and detail-oriented Registered Nurse to work as a critical member of our procedural care team. The successful candidate will be responsible for...

  • Registered Nurse

    2 weeks ago


    Braintree, Massachusetts, United States Mass General Brigham Full time

    Job Title: Registered Nurse - Endoscopy SpecialistMass General Brigham is seeking a highly skilled Registered Nurse to join our Endoscopy team in Braintree, Massachusetts.Job Summary:We are looking for a dedicated and experienced Registered Nurse to work as a critical member of our procedural care team. The successful candidate will be responsible for...


  • Braintree, Massachusetts, United States Mass General Brigham Healthcare at Home Full time

    Job SummaryWe are seeking a skilled Registered Nurse to provide high-quality clinical services to patients in various community settings. As a member of our interdisciplinary team, you will deliver patient care within our organizational philosophy, policy, and standards of community health practice.Key ResponsibilitiesProvide skilled nursing care, including...


  • Braintree, Massachusetts, United States Incredible Health Full time

    {"h2": "Clinical Research Nurse Position at Incredible Health ","ul": [{"li": "We are actively hiring for a Clinical Research Nurse at our hospital in Long Branch, NJ. This is a great opportunity for nurses with experience in clinical trials, oncology, or peer review to join our team and contribute to the advancement of medical research."}, {"li": "As a...

  • Registered Nurse

    3 weeks ago


    Braintree, Massachusetts, United States Mass General Brigham Full time

    Job Title: Registered Nurse - Endoscopy SpecialistMass General Brigham is seeking a highly skilled Registered Nurse to join our Endoscopy team in Braintree, Massachusetts.Job Summary:We are looking for a dedicated and detail-oriented Registered Nurse to support the quality, efficiency, and satisfaction of care taking place at our South Shore Endoscopy Center...


  • Braintree, Massachusetts, United States Incredible Health Full time

    Job Title: Clinical Nurse CoordinatorIncredible Health is seeking a skilled Clinical Nurse Coordinator to join our team in the Long Branch, NJ area. As a Clinical Nurse Coordinator, you will play a vital role in coordinating patient care services and ensuring optimal patient outcomes.Responsibilities:Coordinate patient care services by liaising with...


  • Braintree, Massachusetts, United States Partners Healthcare System Full time

    About Mass General Brigham Healthcare at HomeWe are committed to providing high-quality, patient-centered care in the comfort of our patients' own homes. Our team of skilled healthcare professionals is dedicated to delivering exceptional care and support to patients and their families.Job SummaryWe are seeking a highly skilled and compassionate Registered...


  • Braintree, Massachusetts, United States Mass General Brigham Healthcare at Home Full time

    Job SummaryWe are seeking a skilled and compassionate Registered Nurse to join our team at Mass General Brigham Healthcare at Home. As a key member of our interdisciplinary team, you will provide high-quality, patient-centered care to individuals in their homes, promoting independence and improving quality of life.ResponsibilitiesAssess patients' needs and...


  • Braintree, Massachusetts, United States Incredible Health Full time

    Job Title: Document SpecialistIncredible Health is actively hiring for a Document Specialist (RN) in the Long Branch, NJ area. This role involves working with clinical pathways, navigation, and utilization review. The ideal candidate will have experience in these areas and be able to work various shifts, including day, night, and mid shifts. Job types...


  • Braintree, Massachusetts, United States Tufts Medical Center Full time

    Job Title: Ambulatory Clinic Nurse LeaderJoin Tufts Medical Center, a leading integrated health system, as an Ambulatory Clinic Nurse Leader. In this role, you will be responsible for providing leadership and direction to nursing staff in the ambulatory clinic setting. Your expertise in patient care and ability to develop and implement evidence-based...