- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, ... and operations for all levels of utilization management review (ie, Precertification and Intake Services, Inpatient...leadership. The Director oversees and leads medical management activities related to precertification utilization … more
- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , and acute inpatient rehabilitation **Preferred ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in… more
- Cambridge Health Alliance (Everett, MA)
- RN Case Manager - Inpatient Case Management Everett Apply Refer a Friend Back **Date Posted:** 09/17/2024 **Requisition Number:** 7716 **Location:** CHA Everett ... Days:** 8:00-4:30pm Rotating Wkends and Holidays **Category:** Registered Nurse **Department:** Inpatient Case Management Everett **Job Type:** Part Time **Work… more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge… more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... management . The clinical scenarios predominantly arise from inpatient or post-acute care environments. The medical director...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Humana (Boston, MA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- Tufts Medicine (Boston, MA)
- …of clinical social work services to patients/clients and families in inpatient , ambulatory and community settings utilizing individual, family or group modalities ... one (1) year supervisory experience. **Preferred Qualifications:** 1. Experience in inpatient psychiatric or mental health setting working with major mental illness,… more
- Beth Israel Lahey Health (Milton, MA)
- …acute care or managed care setting + 2 years prior experience in Case Management , preferred (Discharge Planning and Utilization Review + Current knowledge of ... you're making a difference in people's lives.** The Case Management Department provides case management services to...to patients in the Emergency Department and on the inpatient units through specially trained registered nurses. These nurses… more
- State of Massachusetts (Boston, MA)
- …team according to established timeframes and procedures. * Provides clinical case management for cases assigned in order to ensure timely and effective delivery ... and management of services identified on the Comprehensive Treatment Plan....in order to enhance patient and family knowledge and utilization of rehabilitation processes and resources. * Documents interventions… more
- Spaulding Rehabilitation (Brighton, MA)
- …is responsible for overseeing the integration of clinical pharmacy services, drug utilization programs, and disease management and is an integral member ... ) **Description** Under the auspices of the Spaulding Rehabilitation Network Pharmacy Director and the Spaulding Hospital Pharmacy Director , the Pharmacy… more
- Tufts Medicine (Melrose, MA)
- …resources for patients and families. c. In collaboration with the director , ensures all staff maintains competency-based practice based upon patient population. ... and providing informed practice. Creating practice changes through research utilization and experiential learning. a. Anticipates and identifies opportunities to… more
- Beth Israel Lahey Health (Westwood, MA)
- …systems to enter and access patient care information. 7. Participates in quality management and utilization review programs. 8. May coordinate the work of ... and safely as promised. Medication compliance monitoring, chronic disease state management , patient consultation, and provider communications are a part of daily… more
- Commonwealth Care Alliance (Boston, MA)
- …Important to Us:** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... based on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into CES (Claims Editing System)… more