2355 Rn Traveler jobs in Massachusetts

Sr Utilization Management Nurse RN - Remote

UnitedHealth Group

Boston, MA 02112

Registered Nurse (RN) with a current, active, unrestricted RN License in Massachusetts
Currently have OR be able to obtain an RAC/CT MDS certification (must have completed certification prior to start date)
4+ years of nursing experience, specifically in long-term care and/or medical record review with knowledge of Medicare and Medicaid
Recent long-term care MMQ, MDS, staff development or management experience (in long-term care)
Experience working within medical insurance and/or healthcare industries
Experience analyzing inventory, researching, identifying, and resolving issues
Experience with defining and managing processes within a team
Experience trouble shooting issues for users within teams, IT, and/or business partners
Proven knowledge of healthcare insurance industry (Medicaid, Medicare, CMS)
Demonstrated knowledge of process flow of UM, including prior authorization, concurrent authorization, and/or clinical appeal and guidance reviews
Must live in the Boston MA Regional Area to conduct daily travel requirements
Ability to travel within geographic territory (state of Massachusetts) at least 90% of the time (some weeks will require 100% travel as business needs dictate) and assist when needed throughout the state of Massachusetts for audits. (Audits will be conducted onsite)
Must have reliable transportation and be able to provide proof of a valid, unrestricted Driver's License and current Auto Insurance

Encode

Boston, MA 02298

CenterWell Home Health

Yarmouth, MA 02664

RN
Graduate of an accredited School of Nursing.
Current state license as a Registered Nurse.
Proof of current CPR certification.
Valid driver's license, auto insurance and reliable transportation.
A minimum of 2 years of experience as a Registered Nurse.
Traditional home health experience is required.
OASIS experience is required.
Foundational knowledge and basic understanding of CMS PDGM is required.
This role is part of Humana's TB screening program. If selected for this role, you will be required to be screened for TB.
This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.