- Commonwealth Care Alliance (Boston, MA)
- …skills to improve CCA enrollee outcomes by impacting care access and utilization , closing care quality gaps, and optimizing member connection to medical, behavioral ... an integral role in reducing high emergency department (ED) and inpatient utilization related to unmet social needs, including housing, food, community resources… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality assurance. +… more
- Datavant (Boston, MA)
- …tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and improve ... experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim...requirements of the role. The estimated base pay range per hour for this role is: $32-$45 USD To… more
- Wellington (Boston, MA)
- …**About the Role** We are seeking a detail-oriented strategic Senior Content Specialist with deep experience in taxonomy, content modeling, digital asset management ... digital assets, ensuring their proper storage, tagging, accessibility, and utilization . Create and enforce asset lifecycle workflows in coordination...to work onsite at a Wellington office four days per week + Boston is the preference but Needham,… more
- Evolent (Boston, MA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
