Nursing Jobs in Newtonville, MA
$62,700 - $100,400 / YEAR
Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as well as monitoring the delivery of healthcare services. Essential Functions: Complete prospective, concurrent and retrospective review such as acute inpatient admissions, post-acute admissions, elective inpatient admissions, outpatient procedures, homecare services and durable medical equipment Identify, document, communicate, and coordinate care, engaging collaborative care partners to facilitate transitions to an appropriate level of care Engage with medical director when additional clinical expertise if needed Maintain knowledge of state and federal regulations governing CareSource, State Contracts and Provider Agreements, benefits, and accreditation standards Identify and refer quality issues to Quality Improvement Identify and refer appropriate members for Care Management Provide guidance to non-clinical staff Provide guidance and support to LPN clinical staff as appropriate Attend medical advisement and State Hearing meetings, as requested Assist Team Leader with special projects or research, as requested Perform any other job related duties as requested. Education and Experience: Associates of Science (A.S) Completion of an accredited registered nursing (RN) degree program required Three (3) years clinical experience required Med/surgical, emergency acute clinical care or home health experience preferred Utilization Management/Utilization Review experience preferred Medicaid/Medicare/Commercial experience preferred Competencies, Knowledge and Skills: Proficient data entry skills and ability to navigate clinical platforms successfully Working knowledge of Microsoft Outlook, Word, and Excel Effective oral and written communication skills Ability to work independently and within a team environment Attention to detail Proper grammar usage and phone etiquette Time management and prioritization skills Customer service oriented Decision making/problem solving skills Strong organizational skills Change resiliency Licensure and Certification: Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required MCG Certification or must be obtained within six (6) months of hire required Working Conditions: General office environment; may be required to sit or stand for extended periods of time Travel is not typically required Compensation Range: $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Hourly Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. 
$70,345.60 - $136,333.60 / YEAR
Site: Mass General Brigham Incorporated 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 Access RN will lead critical system-wide coordination efforts by adopting a system mindset and leveraging their clinical expertise, situational awareness, and knowledge of MGB hospital capabilities to match patients with the right site of care efficiently and effectively. This centralized role aims to ensure timely access to care, reduce transfer delays, balance patient flow, activate standardized transfer pathways, and foster close collaboration with the multidisciplinary MGB PTAC team and site-based clinical and operational leaders. Does this position require Patient Care? Yes Essential Functions -Facilitates and coordinates closely with hospital bed management teams in the MGB Capacity Center to facilitate patient movement and placement across the system. -Elicits patient information from the referring MD and the outside facility nurse to allow appropriate patient triage and placement. Follows admission using the Transfer matrix and alternative pathways based on bed availability in collaboration with patient access services to appropriate beds based on bed availability and triage information. Collaborates with off-shift nurse administrators regarding ED, procedures, and inpatient arrivals. -Monitors the notification process for inpatient responding clinicians, appropriate documents including data collection, IPASS expect notes, transfer modules, emails, code activations, and reporting to senior leadership. Access nurses notify the team and inpatient service of admission via email to attending physicians; expect a note to be placed for house staff, and collaboration with the referring physician callback for specific information. -Serves as a department representative and consults with appropriate administrators, patient care unit leadership, procedural unit leadership, and access services during the extreme census—updates physicians and transferring facilities on bed availability. Attend daily huddles and represent the PTAC. -Responsible for making critical decisions on directing patients to the appropriate care pathway across various diagnoses, clinical scenarios, and operationally challenging situations. -Identifies patients who are safe and appropriate for standardized transfer pathways that avoid the ED and/or reduce the load on inpatient bed capacity at MGB hospitals. Coordinate these transfers with hospital-based and other MGB asset-based physicians, nurses, and capacity leaders. Qualifications Education Bachelor's Degree in Nursing required Licenses and Credentials: Registered Nurse [RN - State License] required Experience 3+ years of adult critical care and/or emergency department experience required Knowledge, Skills and Abilities Must work well independently, have sound decision-making skills, and have flexibility to assist in times of emergency or increased need. Responsible for contributing to a calm, organized, appreciative, learning-oriented atmosphere. Proactively seeks out feedback and communicates development goals. Additional Job Details (if applicable) Remote Type Onsite Work Location 399 Revolution Drive Scheduled Weekly Hours 32 Employee Type Regular Work Shift Night (United States of America) Pay Range $70,345.60 - $136,333.60/Annual Grade 6NTEMP 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: 0100 Mass General Brigham Incorporated 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 (857)-282-7642. 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. 
$125,000 - $130,000 / YEAR
Are you looking for a meaningful career caring for our communities most vulnerable populations? The Edward M. Kennedy Community Health Center is one of the largest community health centers in Massachusetts serving Worcester, Framingham, Milford and the surrounding communities. We are a thriving and growing organization, and our team is expanding across sites to support this growth. As an employer of choice, our inclusive workplace environment fosters teamwork, accountability and respect and supports the growth and development of each employee. We are an equal opportunity employer and embrace the richness of the cultures of our staff and community. You are a good fit for our team if you’re passionate about helping people live healthier lives and enjoy working in a supportive, team-based environment. Job Summary : The Advanced Practice Provider Trainer is a member of the clinical practice team and works collaboratively with the fellow team members in providing patient care. This role is responsible for training and evaluating 2 – 3 new, hired in the last two years, Advanced Practice Providers, nurse practitioners and/or physician who are not participating in the NP Residency program. As part of the team-based approach to care, the Trainer participates in coordinating care for individual patients, supports patients and families in self-management, through evidenced-based approaches as may be appropriate, engages in health center projects that are aimed at specific patient population needs, and utilizes effective and appropriate communication strategies, such as health literacy approaches when working with patients. Essential Functions: Mentoring/Training: (approximately 20 hrs.) 1. Supervise, train and evaluate new Advanced Practice Providers (NP and/or PA). 2. Perform chart reviews based on an established schedule. a. All charts for the first month of a new hire’s employment. b. Up to 10 chart reviews for each month following. 3. Coordinate MAVEN Services which include: a. Coordinate CME educational sessions with site medical directors b. Meet with APP assigned MAVEN mentor at designated times to begin after new APPs 3rd month of employment 4. Observe and shadow APP 5. Evaluate APP based on accepted competencies which will include: a. History taking b. Physical exam skills c. Analyzing data d. Management/ plan formation e. Procedures f. Problem solving hazards and biases g. Medical practice and principles 6. Provide constructive feedback to APP for the course of two years and possibly longer as the APP develops into the role. 7. Support organizational compliance and training requirements and work with APPs to complete any required or newly required trainings. 8. Participate in Administrative Projects as assigned by the Medical Director. Clinical: (approximately 20 hrs.) 1. Provide direct medical care for four sessions per week , complete clinical administrative work four hours per week. 2. Adhere to established protocols, responds to medical emergencies within the facility assigned. 3. Assists/instructs other health care employees in the management of client care. 4. Make referrals to health care professionals, specialists, other clinics and community agencies. Experience and Skills: .Current and unrestricted APP (Nurse Practitioner or Physician Assistant) license in Massachusetts · Board Certified in Family Medicine preferred, (Board Certified with ABMS) · Knowledge of Quality Improvement Principles and Practice · Knowledge of clinical problems and barriers to access of vulnerable patient populations · Minimum 3 years’ experience working with Electronic Health Records (EHR). · Excellent communication and problem-solving skills. · Management experience within an ambulatory setting. Benefits $125,000-$130,000 + yearly bonus incentive All pay rates are subject to experience, licensure or certification, and location Generous time off package including 4 weeks of paid vacation, 11 paid holidays, 3 personal days, 5 sick days and 3 extended sick days. 32 hours of clinical time and 8 hours of administrative time that can be completed remotely Qualifies for the Federal and State Loan Repayment Programs Health Insurance plans starting on day-1 of employment. Employer pays 80% of medical insurance premiums Dental Insurance and Vision Insurance options Short-Term and Long-Term Disability paid 100% by employer Competitive Retirement Plan with company match CME Reimbursement Visa Sponsorship Offered 
Responsible for oversight of compliance with performance improvement standards associated with regulatory and accrediting bodies. Incorporates Alliance’s mission in guiding all departments in Measuring Performance through data collection, assessing current performance improvement and development of improvement processes. Systemically aggregates and analyzes data. Reviews undesired patterns or trends in performance. Ensures that analyzed information is used to make changes in improvement process and performance measures are used to determine whether changes result in desired outcomes. Also includes an education element and is responsible for the coordination, planning and direction of all facility education and training programs. Programs include but are not limited to, orientation and professional development consistent with the goals of the organization. Part time position, 24 hrs per week 
