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Utilization Management Clinical Reviewer

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 UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, determine the need for physician review, and complete determinations following physician review. This role is primarily responsible for conducting utilization management reviews for post-acute and extended care services, including Skilled Nursing Facility (SNF), Acute Rehabilitation, and Long-Term Acute Care Hospital (LTAC) admissions and continued stays. The ideal candidate will have prior authorization and utilization management experience in a managed care setting, with experience doing post-acute authorizations, which includes SNF (skilled nursing facility), LTAC (long-term acute care), and IPR (inpatient rehabilitation). Strong clinical judgment, familiarity with post-acute levels of care, and the ability to apply medical necessity criteria to support timely and appropriate coverage decisions are essential for success in this role.

Principal Duties and Responsibilities:

• Ensures post-acute services (rehabilitation, skilled nursing, long-term acute care, home care) are clinically appropriate and aligned with best practices.
• Guides decisions on admission, continued stay, transfer readiness, or discharge.
• Serves as a first-level screening, with physician oversight when criteria are not fully met.
• Accounts for patient severity of illness, comorbidities, and complications.
• Includes objective endpoints for recovery, plateau, or goal achievement to inform care planning.
• Proficient with Microsoft Word, Excel, Outlook, McKesson InterQual, 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

• Post-acute utilization review experience (SNF, Rehab, LTAC) UM experience highly preferred
• 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.

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.
• Remote workdays require a stable, secure, quiet, and HIPAA-compliant workspace. This will be confirmed via Microsoft Teams video for all employees
• Monday through Friday eastern business hour required

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

Registered Nurse - Medical/Surgical (M/S)

Damariscotta, ME

Job Type: Contract

Specialty: Medical/Surgical (M/S)

Start Date: 09/06/2026

Description

$2,131.92 - $2,368.80 Weekly *Rate is comprised of taxable hourly rate, specifically including if applicable, nontaxable (housing and M&IE) stipends converted to an hourly rate based on a 36-hour work week, and may be eligible for overtime We can help you achieve your career goals by connecting you to our diverse healthcare clients close to home or in desirable locations throughout the United States. Choose to serve patients in major medical centers, community-based hospitals, outpatient clinics, sub-acute care & rehab hospitals, correctional and long-term care facilities, and more. Our team members will match you with the facility that corresponds to your personal and professional goals. Accountable Benefits include Medical, Dental, Voluntary Vision, Life and ADD, Critical Illness, Hospital Indemnity, Flexible Spending, Legal Services, Voluntary Accident Insurance, Pet Insurance, Short Term Disability Insurance and Matching 401K. EEO/Minority/Female/Individuals with Disabilities/Sexual Orientation/Gender Identity/Veteran Yep, we're Accountable!

Join the Rockler Woodworking Family

Are you passionate about woodworking or DIY projects? Do you thrive on helping others turn their creative visions into reality? Look no further! Join the Rockler family, a dynamic and innovative company dedicated to empowering woodworkers and do-it-yourselfers with top-notch products, education, and advice. Learn more about our company at www.rockler.com

Why Rockler?

Be part of a family-owned business that cherishes its customers and employees alike.

Join an industry leader committed to providing the most innovative products, ideas, and education to woodworking enthusiasts.

Embrace a culture that values teamwork, creativity, and a genuine passion for craftsmanship.

Summary of Position

This is a part-time customer service role in which the sales associate gives the customer their immediate and complete attention by explaining, demonstrating, and selling woodworking supplies and tools. When not engaged with a customer, the focus should be on the maintenance of the sales floor including facing, dusting and general housekeeping.

Major Areas of Accountability

• Greets customers as they enter the stores. Greetings should be made within an acceptable period of time ensuring that the customer is welcomed in the store. All customers must be acknowledged when encountering them.
• Handles all aspects of retail sales of company products by answering questions on product application or use, ringing the sale on the POS.
• Special emphasis should be placed on the "Total solution" which means that any related products/services the customer might need for the project should be shown.
• Assists with the maintenance and merchandising of the store to maintain neat, orderly, well stocked, and appealing displays.
• Handles customer refunds and prepares necessary documentation in accordance with prescribed procedures.
• Refers customers to other sources if we do not have the specific item with the intent of building goodwill for Rockler Companies, Inc.
• May assist with unloading trucks, pricing and merchandising or any other duties as assigned.
• Attendance is an essential function of this position, and we rely on all our employees to be at work during their scheduled shift.

Requirements for Position

• Minimum of high school graduate or GED.
• Knowledge of woodworking and hand tools required.
• Previous retail sales experience desirable
• Ability to understand the nature of customers' requests and how best to respond to their needs.
• Ability to understand situations where a return or refund of merchandise can be authorized.
• Requires an extremely strong service orientation to maximize customer satisfaction.
• Ability to be a team player, outgoing, approachable, and congenial when dealing with both customers and other associates.
• Must be able to stand for long periods of time, personally lift up to 50 lbs. on a regular basis and participate in team lifting.
• Takes Initiative
• Excellent Team Player

Employee Benefits:

• Generous employee discounts
• Employee discount pricing from various manufacturers
• Paid vacation & holidays (for full-time positions only)
• Medical, Dental, & Vision plans (for full-time positions only)
• 401K
• A FUN PLACE TO WORK!

Rockler Companies is an Equal Opportunity Employer Committed to Inclusion and Diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Occupational Therapist (OT)

Plumas District Hospital is seeking a dedicated and skilled Occupational Therapist (OT) to join our multidisciplinary team. In this role, you will apply professional judgement and clinical expertise to evaluate and treat patients across inpatient, swing bed, outpatient, and skilled nursing settings. You will assess functional abilities, develop personalized treatment plans, and help patients improve their independence and quality of life.

Location

You may be requested to travel between the two offices situated in Quincy, CA, and Greenville, CA.

Compensation

Compensation for Benefited, Full-Time Pay Scale

• Base Rate: $69.94$99.74 per hour (or $145,475.20$207,412.85 annually)
• Starting pay is determined using our clinical pay scales, which feature 13 steps recognizing up to 30 years of relevant experience.
• Eligible employees may also receive shift differential and holiday pay
• Sign on Bonus: $10,000.00
• Housing Stipend: $1,500 / month relocation assistance for 3 months, if you do not currently have housing available within 35 miles of PDH and need to relocate to accept the offered position.

Compensation for Non-Benefited, Full-Time Pay Scale

• Base Rate: $70.11$99.96 per hour (or $145,822.56$207,908.10 annually)
• Starting pay is determined using our clinical pay scales, which feature 13 steps recognizing up to 30 years of relevant experience.
• Eligible employees may also receive shift differential and holiday pay

Job Status / Shift Information

• Full-time
• May work across inpatient, swing bed, outpatient, and skilled nursing departments

Qualifications

Required Education:

• Bachelor's, Master's, or Doctorate in Occupational Therapy from an accredited institution
• Active California Occupational Therapist License (in good standing)
• Current AHA Healthcare Provider BLS certification
• Compliance with California OT regulatory requirements

Preferred Experience:

• 23 years of experience in acute care, rehabilitation, or outpatient settings
• Strong communication and interpersonal skills
• Proficiency with computers and EMR documentation
• Ability to independently manage diverse caseloads
• Excellent problem-solving and analytical thinking
• Compassionate patient-centered care approach
• Commitment to continuous professional learning

Responsibilities

• Provision of assessment and evidence-based treatments.
• Skill in the wide range of basic evaluation instruments.
• Ability to modify and/or adapt treatment techniques to improve outcomes.
• Participation in PI/QA programs.
• Participation in departmental meetings.
• Supervision of COTA/aid, as needed

Benefits / Perks

Benefits for Eligible Employees

The following benefits are available to eligible full-time and part-time employees following applicable waiting periods:

• Comprehensive medical, prescription drug, dental, and vision plans
• PDH Employee Discount Program, which waives applicable deductibles and coinsurance for eligible services received at Plumas District Hospital
• Generous paid time off (PTO) accrual
• Paid leave for continuing education, bereavement, and jury duty
• Employer-sponsored retirement plans featuring:
• A 3% employer contribution
• An employer match of 50% of employee contributions, up to the plan maximum
• $20,000 in employer-paid life insurance
• Voluntary benefit options, including additional life insurance, long-term disability insurance for full-time employees, and identity theft protection
• Potential loan-forgiveness opportunities for eligible healthcare professionals
• Educational and career-development support, including Certified Medical Assistant training, an LVN-to-RN step-up program, and tuition reimbursement

On average, employer-provided benefits add approximately 40% to the value of an employee's total compensation package.

Perks Available to Employees

• Paid sick leave, with five days awarded annually based on the employee's anticipated work schedule
• An inclusive, supportive, and connected work environment
• Discounted rates at the PDH Child Care Center
• Competitive compensation
• The opportunity for all employees to contribute to an employer-sponsored retirement plan
• Discounted CareFlight/AirMedCare Network memberships
• Shift differentials for eligible shifts and PDH-observed holidays

Why Plumas District Hospital

Work in a setting with rugged canyons, crystal clear lakes, grassy meadows, trout-filled streams, fresh pine forests, and brilliant star-filled skies. This is your chance to provide compassionate care with exceptional customer service at Plumas District Hospital. With a diverse population with people from all walks of life, PDH team members provide the residents of Quincy and the surrounding area with essential health care services that are vital to this small mountain community. PDH is located in Quincy, California which is the largest community in Plumas County and has a population of 5,000 residents. Quincy is nestled against the Western slope of the Sierra Nevada mountain range and tucked in at the edge of the lush American Valley. Chico, California is 80 miles west and Reno, Nevada is 80 miles east of Quincy. Join a medical team that puts community first.

Contact Information

Recruiter Name/Email: Nicholas Clawson, nclawson@pdh.org

Department Phone: 530-283-7169

MRI Tech

This position is for an MRI Tech with a focus on providing quality imaging services. The tech works 5 days a week from 12:30 PM to 9:00 PM. On-call requirements include coverage Monday through Friday from 6:00 PM to 5:30 AM, as well as weekends starting at 5:30 AM on Saturday until Monday morning at 5:30 AM. The facility may call off one shift every two weeks. Travelers may be assigned to emergency response teams during hurricane season, which runs from June to November. The facility utilizes Epic for charting, and staff are expected to maintain a scrub color of black pants and teal tops. Local candidates within a 60-mile radius may be considered on a case-by-case basis. Applicants should ensure they do not have any planned time off that could interfere with the compliance process. Prior experience with Philips equipment is preferred.

We offer competitive benefits, including:

• Medical, dental & vision insurance
• Free and unlimited continuing education units (CEUs)
• 24/7 dedicated Care Line and clinical liaison support
• Personalized career consultant and "single point of contact" service
• Industry?leading pay rates, loyalty rewards & referral bonuses
• Free tax return assistance for travelers
• 401(k) Retirement Plan
• Health Savings Account (HSA)
• Disability Insurance (Short-Term and Long-Term)
• Life and AD&D Insurance
• Paid Sick Leave (where required by applicable state or local law)
• Supplemental Insurance Plans
• Identity Theft Protection
• Pet Insurance
• Employee Wellness Programs
• Employee Assistance Program (EAP)
• Career Growth and Professional Development Opportunities

Benefits eligibility, accrual rates, and usage limits may vary based on employment status, length of service, and work location. Paid Sick Leave is provided in strict accordance with applicable state and municipal mandates. Cynet Health reserves the right to modify, amend, or terminate any benefit plans at any time in accordance with applicable laws.

Cynet Health is a Joint Commission-accredited, Minority-Owned healthcare staffing agency headquartered in Sterling, Virginia, proudly serving healthcare facilities across the United States since its founding in 2010. As one of the nation's largest and fastest?growing healthcare staffing firms in the nation, we staff thousands of nursing, allied health, locum tenens, pharmacy, therapy, direct?hire, and non?clinical professionals across hospitals, clinics, long?term care facilities, labs and more. We're one of the most decorated staffing agencies in America-ranked a Top Travel Nursing Company by BluePipes, recognized among the fastest?growing and most diverse staffing firms by Inc. 5000, Staffing Industry, WBJ and USPAACC-and remain deeply committed to excellence, inclusion, and community impact.

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Medical Assistant (CMA)

JHCP is looking for a Medical Assistant (CMA) to provide high quality care to patients at our Internal/Family Medicine practice in Frederick, Maryland located in Frederick County. The Medical Assistant administers medications and immunizations, obtains vital signs, maintains inventory of appropriate supplies, ensures safe and efficient patient flow, tracks high-risk referrals and lab tests, facilitates safe transitions of care, organizes practice environment to assure patient safety and quality outcomes, and contributes to HEDIS and designated quality measures.

What awaits you!

• Medical, Dental, Vision
• 403B Savings Plan
• Paid Time off & Paid holidays
• Employee and Dependent Tuition benefits
• Free Parking
• Refer a friend to Johns Hopkins, opportunity to earn $$$
• Health & Wellness programs and more!

Location: 45 Thomas Johnson Drive, Frederick, MD 21702

Shift: Non- Exempt - Full-time - 40 hours per week - 8:00 a.m. - 5:00 p.m., Tuesdays 11:00 - 8:00 p.m.

What You'll Need to be Successful:

• High School Diploma or GED required.
• Certified Medical Assistant required successful completion of the AAMA, RMA/AMT, NCRMA (NAHP), NCMA(NCCT), RCMAS(NCMA), or CCMA(NHA). Medical Assistant Certification, exam within 3 months of hire. Five or more years of specific applicable MA experience in primary medical care may be substituted for formal training program provided eligibility for RMA(American Medical Technologists) exam. A valid CPR certification required upon hire and recertification required every two years.
• Two years experience preferred.

Salary Range: Minimum /hour - Maximum /hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Assistant Director

The Assistant Director prescribes nursing care, delegates nursing activities, and coordinates the assessment, planning, implementation and evaluation of patient care to provide optimal quality care, consistent with the hospital's mission and nursing philosophy, objectives, standards and bylaws. The Assistant Director works with the Director in the coordinating and directing of staff and patient care activities for the promotion of quality patient care. The Assistant Director is responsible for the CQI activities of the unit and for ensuring all staff members attend required inservice education programs. Has full access to patient health information.

Requirements:

• Current Registered Nurse Licensure in
• Staff Nurse experience required.
• BSN required or significant work toward completion (current incumbents as of 1/1/2010 are excluded from this requirement).
• Management experience preferred.
• Must possess full range of body motion to pass a basic FIT test to include bending, stooping, standing and sitting for extended periods of time. Must be able to lift and carry up to 30 pounds.

Travel Physical Therapist Assistant

Travel Physical Therapist Assistant jobs in Jacksonville, AL let you support outpatient therapy, helping patients regain mobility and function under the supervision of a licensed physical therapist. You will implement treatment plans, guide patients through therapeutic exercises, document progress, and educate patients on home exercise programs and injury prevention. Recommended skills include strong communication, teamwork, and proficiency with therapy documentation systems. Required qualifications are an associate degree from an accredited PTA program and an active Alabama PTA license. Jacksonville, AL offers a welcoming community, outdoor recreation, and convenient access to local attractions. With AMN Healthcare, you receive excellent compensation, exclusive discounts, dedicated recruiters, and support from the AMN Passport app, all backed by the high ethical standards of a publicly traded company.

Job Title

Location 241 Ralph McGill Blvd, Atlanta, GA, 30308, United States

Base Pay $30.00 - $31.45 / Hour

Required Degree 4 Year Degree

Travel 15%

Minimum Experience 5 Years

Contact Information

Name Kevin Lewis

Email klewis@blocresources.com

Description Requirements Summary