Nursing Jobs in Ipswich, MA
$90,000 - $107,000 / year
Site: Mass General Brigham Health Plan Holding Company, Inc. 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 Given equity, this position will pay somewhere between $90,000 to $107,000 annually. Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. The UM Nurse will support network adequacy review and authorization activities for members enrolled in ACO, HMO, and EPO products who require planned inpatient or outpatient services from out-of-network providers. Utilizing clinical knowledge, the UM Nurse will review prior authorization requests, assess medical necessity and benefit coverage, render approval decisions within scope, determine when physician review is required, and complete determinations following physician review. The ideal candidate will have prior authorization experience in a managed care setting and possess strong commercial health plan knowledge. Essential Functions: • Expertise in clinical review for prospective, concurrent, retrospective utilization management reviews utilizing Interqual ®, company policies and procedures, and other resources as determined by review, including physician reviews as needed for all lines of business as per departmental needs • Review authorization requests for medical services, including making initial eligibility and coverage determinations, screening for medical necessity appropriateness, determining if additional information is required, and referral to correct programs within Mass General Brigham Health Plan as needed. • Manage incoming requests for procedures and services including patient medical records and related clinical information. • Strong working knowledge of commercial, self-insured, fully insured, and limited network plans. • Adherence to program, departmental, and organizational performance metrics, including productivity. • Excellent verbal and written communication skills. • Excellent problem-solving and customer service skills. • Would need to be available for “on call” for a minimum of once per month with the possibility of that increasing depending on staff availability; Approximately 6 months after hire. • Must be self-directed and highly motivated with an ability to multitask. • Develop and maintain effective working relationships with internal and external customers • Hold self and others accountable to meet commitments. • Sound decision-making and time management skills. • Proactive in areas of professional development, personally and for the department. • Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise. • Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization. • Proficient with Microsoft Word, Excel, Outlook, McKesson InterQual ®, Outlook, SharePoint, PC based operating system, and web-based phone system. Qualifications Education Associate's Degree Nursing required or Bachelor's Degree Nursing preferred Licenses and Credentials Massachusetts Registered Nurse (RN) license required Experience At least 2-3 years of utilization review experience is highly preferred Experience using Interqual or Milliman is highly preferred At least 1-2 years of experience in a payer setting is highly preferred At least 1-2 years of experience in an acute care setting is highly preferred Knowledge, Skills, and Abilities Demonstrate Mass General Brigham Health Plan’s core brand principles of always listening, challenging conventions, and providing value Strong aptitude for technology-based solutions. Embrace opportunities to take the complexity out of how we work and what we deliver. Listen to our constituents, learn, and act quickly in our ongoing pursuit of meaningful innovation Current in healthcare trends. Ability to inject energy, when and where it’s needed. Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback. Be accountable for delivering high-quality work. Act with a clear sense of ownership. Bring fresh ideas forward by actively listening to and working with employees and the people we serve. Communicate respectfully and professionally with colleagues Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback. Knowledge, Skills, and Abilities Demonstrate Mass General Brigham Health Plan’s core brand principles of always listening, challenging conventions, and providing value Strong aptitude for technology-based solutions. Embrace opportunities to take the complexity out of how we work and what we deliver. Listen to our constituents, learn, and act quickly in our ongoing pursuit of meaningful innovation Current in healthcare trends. Ability to inject energy, when and where it’s needed. Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback. Be accountable for delivering high-quality work. Act with a clear sense of ownership. Bring fresh ideas forward by actively listening to and working with employees and the people we serve. Communicate respectfully and professionally with colleagues Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback. Additional Job Details (if applicable) Working Conditions Would need to be available for “on call” for a minimum of once per month with the possibility of that increasing depending on staff availability; Approximately 6 months after hire. This is a remote role with occasional onsite team meetings in Somerville, MA. Monday through Friday, eastern business hours required Remote workdays require a stable, secure, quiet, and HIPAA-compliant workspace. This will be confirmed via Microsoft Teams video for all employees Given equity, this position will pay somewhere between $90,000 to $107,000 annually. Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $58,656.00 - $142,448.80/Annual Grade 98TEMP 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: 8925 Mass General Brigham Health Plan Holding Company, Inc. 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. 
Responsibilities What you will do as a CNA Enhance the lives of older adults by assisting them with mobility needs and daily living activities, including housekeeping, bathing, grooming, and routine personal tasks Work cooperatively with other talented team members to support and care for residents Receive on-the-job training and have opportunities for career growth and advancement Solve problems and exhibit ethical behavior Qualifications Must be Certified Nursing Assistant or Certified Home Health Aide Apply today to join the Atria team. We will provide you with all the additional training you need! Atria is an equal opportunity employer committed to providing equal employment opportunities without regard to race, color, religion, sex (including pregnancy), sexual orientation, age, national origin, disability, genetic information, veteran status, or any other classification protected by applicable law. 
$73,881.60 - $143,156 / year
Site: The Brigham and Women's Hospital, Inc. 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 Bed Access Nurse Manager / Full Time 36Hours / BWH Boston Main Campus This position involves managing capacity and access, ensuring safe, efficient, and timely patient care, and working to coordinate and optimize all incoming hospital transfers and referrals for the system and triage patients, reducing transfer delays, balancing the flow of transfers, and coordinating standardized transfer pathways. Responsibilities: Elicits patient information from referring MD and outside facility nurse to allow appropriate patient triage and placement. -Using triage tools and algorithms, working in collaboration with patient access services and others to transfer the patient in a clinically appropriate timeframe. -Acts as a liaison to provide and ensure continuity of care for the patient and family and is a clinical resource for the financial navigator. -Assessment of patients and families before their initial consultation requires initial nursing assessment, which may include intake, diagnosis, history, physical symptoms, psychosocial assessment, cultural assessment, and educational needs. -Collaborates with and coordinates providers and support staff to facilitate appropriate decision-making that will provide complete and comprehensive care to the patient and family. -Utilizes established systems to document the reason for visit, testing ordered/completed, referrals made, and current medication list. Qualifications Education: Bachelor's Degree Nursing required. This role cannot this role accept experience in lieu of a degree. Licenses and Credentials: Registered Nursing License in Massachusetts is Required Experience: Clinical nursing experience 2-3 years required. Patient flow, access nurse, or bed control experience 1-2 years preferred. Knowledge, Skills and Abilities: Possesses interpersonal skills to interact effectively with intra-inter and outside-hospital physicians and personnel. Strong theoretical and experiential knowledge of nursing practices. Must possess skills to work well independently and have sound decision-making skills. Possesses the ability to manage critical issues relating to patient care and changing organizational climate. Additional Job Details (if applicable) Remote Type Onsite Work Location 75 Francis Street Scheduled Weekly Hours 36 Employee Type Regular Work Shift Rotating (United States of America) Pay Range $73,881.60 - $143,156.00/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: 2200 The Brigham and Women's Hospital, Inc. 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. 
$95,000 - $105,000 / year
Whittier Rehabilitation Hospital - Transitional Care Unit Case Manager/Discharge Planner Full-Time, 40 hours per week $95,000 - $105,000 annually plus a $5,000 Sign On Bonus Must be a licensed RN in the State of Massachusetts We are looking for a seasoned Case Manager (RN preferred) to provide case management for our patients in our 20 bed Transitional Care Unit housed within our Rehabilitation Hospital. This person will be part of our overall hospital Case Management team. Primary Responsibilities: To oversee and coordinate each patient's TCU stay beginning with admission through discharge. Work with all members of the interdisciplinary care team to identify goals, address barriers to discharge and ensure patient receives the optimum rehabilitation services in the most efficient manner. Provide the patient and family information about the rehabilitation process, levels of care, and patient rights/responsibilities. Work within the confines of CMS guidelines and/or Managed Care expectations, able to advocate for patients when possible. Ensure patient is provided with appropriate resources befitting next level of care setting (e.g., list of skilled nurse facilities, available home health agencies, etc.). Maintain appropriate patient and family contact regarding patient progress towards goals, care team discussions, as well as continual review of discharge planning efforts to ensure a safe and timely discharge plan is in place. Address disposition changes in timely manner, remaining proactive in anticipating patient's discharge needs. Prerequisites: Registered Nurse with 2-5 years acute case management experience in SNFstrongly preferred Excellent communication (written and verbal), interpersonal and organizational skills. Ability to assess, analyze, plan, implement and evaluate plan of care. Basic knowledge of CMS guidelines, Managed Care products, and criteria for short term SNF care Benefits Available; 401(k) Paid vacation, sick and holiday Dental insurance Medical insurance Vision insurance Health Savings account Flexible spending accounts Life insurance and Disability policies Hospital, Critical Illness, Accident policies $95,000 - $107,000 / year
Whittier Rehabilitation Hospital - Transitional Care Unit Case Manager/Discharge Planner Full-Time, 40 hours per week $95,000 - $107,000 annually plus a $5,000 Sign On Bonus Must be a licensed RN in the State of Massachusetts We are looking for a seasoned Case Manager (RN preferred) to provide case management for our patients in our 20 bed Transitional Care Unit housed within our Rehabilitation Hospital. This person will be part of our overall hospital Case Management team. Primary Responsibilities: To oversee and coordinate each patient's TCU stay beginning with admission through discharge. Work with all members of the interdisciplinary care team to identify goals, address barriers to discharge and ensure patient receives the optimum rehabilitation services in the most efficient manner. Provide the patient and family information about the rehabilitation process, levels of care, and patient rights/responsibilities. Work within the confines of CMS guidelines and/or Managed Care expectations, able to advocate for patients when possible. Ensure patient is provided with appropriate resources befitting next level of care setting (e.g., list of skilled nurse facilities, available home health agencies, etc.). Maintain appropriate patient and family contact regarding patient progress towards goals, care team discussions, as well as continual review of discharge planning efforts to ensure a safe and timely discharge plan is in place. Address disposition changes in timely manner, remaining proactive in anticipating patient's discharge needs. Prerequisites: Registered Nurse with 2-5 years acute case management experience in SNFstrongly preferred Excellent communication (written and verbal), interpersonal and organizational skills. Ability to assess, analyze, plan, implement and evaluate plan of care. Basic knowledge of CMS guidelines, Managed Care products, and criteria for short term SNF care Benefits Available; 401(k) Paid vacation, sick and holiday Dental insurance Medical insurance Vision insurance Health Savings account Flexible spending accounts Life insurance and Disability policies Hospital, Critical Illness, Accident policies