Nursing Jobs in Bellingham, 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. 
$66,575 - $142,576 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Location: 2000 Diamond Hill Rd #108, Woonsocket, RI 02895 Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $142,576.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan . No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit 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. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/29/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. $285,000 - $310,000 / year
Overview Join a Mission-Driven Team at Fallon Health Summit ElderCare! Position: SNFist (Skilled Nursing Facilityist) – PACE Program in WORCESTER, MA Salary Range: $285,000–$310,000/year, based on skills and experience. At Fallon Health, we don’t just offer jobs—we offer purpose. As part of our Summit ElderCare PACE program , you’ll be at the forefront of a growing, innovative model of care that helps older adults live safely and independently at home. If you’re passionate about quality over quantity , enjoy working in a collaborative interdisciplinary team , and want to make a real difference in the lives of frail elders, this is the opportunity for you. Work-Life Balance: Monday–Friday, 8-hour days with a flexible schedule , and an optional administrative day with no direct patient care . Patient-centered Care: See an average of 5 -6 patients per day Team-based Culture: Work alongside a dedicated interdisciplinary team of geriatric care professionals Mentorship & Growth: Benefit from strong peer mentorship and leadership support Mission-driven Work: Help frail elders avoid nursing home placement and live with dignity in the community "PACE is the future of elder care—and Fallon Health is leading the way. If you’re looking for a career where your time, expertise, and compassion truly matter, Summit ElderCare is the place to be." About us: Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities enable us to serve our members better. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. The Summit Eldercare skilled nursing facility physician is responsible for providing high-quality, participant-centered care to patients in skilled nursing facilities (SNFs). He/she will manage medically complex, post-acute and long-term care participants residing in Skilled nursing facilities. He/she will be responsible for initial and ongoing care at the assigned SNFs, optimizing participants’ health outcomes, in coordination with the SNF and Summit Eldercare Interdisciplinary team. Responsibilities Clinical care and oversight Review and cosign (when required) interdisciplinary documentation to ensure accuracy and regulatory alignment. Perform duties including, but not limited, to admission H&P, regulatory required physician visits, medications and treatment plans review, signatures on all orders and progress notes. Manage and coordinate treatment for participants with multiple chronic medical problems, acute/arising conditions, and complex medication regimens Lead and oversee all transitions, including hospital to SNF, ensuring timely and effective care Conduct daily or scheduled rounds in assigned skilled nursing facilities (SNFs) Collaborate closely with the SNF staff i.e. nursing staff, Director of nursing, rehab team, etc. Coordinate closely with the Summit Eldercare interdisciplinary team members Participate in daily SE IDT meetings and communications as needed to ensure effective, appropriate, and coordinated care Communicate effectively with participants, caregivers, facility staff and SE IDT members regarding patient goals, treatment plans and care transitions Build and sustain trusted relationships with SNF medical directors, Directors of Nursing, and key SNF clinical leaders to enhance care consistency and collaboration between SNFs and Summit Eldercare Maintain a regular, visible presence in each assigned SNF, promoting physician accessibility and adherence to PACE principles Partner with hospitalist, SE primary care provider and other team members, to support smooth transitions of care and reduce hospital admissions and readmissions Collaborate with SE team in meeting related utilization metric and MLR goals Regulatory compliance Ensure compliance with all CMS physician services requirements for SNFs, including required visit frequency, supervision requirements, medical oversight, and documentation standards When applicable, supervise advanced practitioners following state law and CMS regulations Document all physician visits and orders in compliance with SNF EMR standards and PACE documentation requirements. Participate in grievances reviews, when applicable, in collaboration with the SE team Review and co‑sign (when required) interdisciplinary documentation to ensure accuracy and regulatory alignment. Qualifications Education: Medical degree (MD or DO) from an accredited school of medicine License/ Certifications: MD or DO licensed in Massachusetts Board Certification in Internal Medicine, Family Practice, or Geriatrics (preferred) DEA certification 1+ year experience with frail or elderly populations Passion for team-based, patient-centered care Experience: 2-3 years’ experience in post-acute care, long-term care or geriatric settings Strong clinical skills in managing complex, frail patients with multiple chronic medical problems, preferably in a skilled nursing facility setting Knowledge in Skilled Nursing Facility (SNF) regulations and standards of care preferred Excellent communication and interpersonal skills Demonstrated ability to work effectively in an interdisciplinary team model, PACE model of care preferred Proficiency in using electronic medical records (EMR) Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $285,000 to $310,000 per year , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01 
$88,000 - $115,000 / year
Grow your career internally at Elara Caring, our best talent comes from within! Job Description: At Elara Caring, we care where you are and believe the best place for your care is where you live. We know there’s no place like home, and that’s why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting. Wherever our patients call home and wherever they are on their health journey, we care. Each team member has a part to play in this mission. This means you have countless ways to make a difference as a Registered Nurse Home Health. Being a part of something this great, starts by carrying out our mission every day through your true calling: developing an amazing team of compassionate and dedicated healthcare providers. To continue to be an industry pioneer delivering unparalleled care, we need a Registered Nurse Home Health with commitment and compassion. Are you one of them? If so, apply today! Why Join the Elara Caring mission? Work autonomy and flexible schedules 1:1 patient care Supportive and collaborative environment Competitive compensation package Tuition reimbursement for full-time staff and continuing education opportunities for all employees Comprehensive insurance plans for medical, dental, and vision benefits 401(K) with employer match Paid time off, paid holidays, family and pet bereavement Pet insurance As a Registered Nurse Home Health, you’ll contribute to our success in the following ways: Ensures that all activities performed align with the vision of Elara Caring’s board of directors, executive team, and the leadership of the Home Health team. Add key accountabilities here. Maintains patient and staff privacy and confidentiality pursuant to HIPAA Privacy Final Rule. Assesses assigned case load of home health care patients and families to identify the physical, psychosocial, and environmental needs of patients as evidenced by documentation, clinical records, Interdisciplinary Team reports, after hours reports, and on-site evaluations. Assumes primary responsibility for caseload, including assessing, planning, coordinating, implementing, and evaluating the plan of treatment. Assesses patient needs and obtains data on physical, psychological, social, and spiritual factors that may influence patient/family/caregiver health status and incorporate that data into the plan of care. Makes the initial evaluation and re-evaluates the patient’s nursing needs during each visit. Makes follow up visits according to patient, family, and facility needs. Communicates significant findings, problems, and changes in health condition, environment, or unsafe facility conditions to the Clinical Supervisor, physician, facility, and/or other personnel involved with patient care. Revises the plan of care in response to identified patient care issues and notifies the Clinical Supervisor, physician, facility, and other team members. What is Required? Current, unrestricted state RN licensee 1+ year experience in a clinical care setting as a nurse Able and willing to travel within branch/office coverage area. Must have a dependable vehicle, valid driver’s license, and current auto insurance in accordance with state laws. Must be able and willing to travel 50% Associates Degree or Bachelor’s Degree in Nursing is preferred Previous Home Health or Hospice Experience is preferred Previous experience with HomeCare HomeBase is preferred You will report to the Clinical Manager or Clinical Supervisor #LI-TR1 This is not a comprehensive list of all job responsibilities and requirements; a full job description will be provided upon request. The base salary for this position is $88,000 to $115,000 annually based on the company’s good faith estimate at the time of posting. Actual pay will be determined based on factors such as education, experience, skills, and internal equity. Elara Caring provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age (40 and older), national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, protected veteran status, or any other basis prohibited under applicable federal, state or local law. 
