- Beth Israel Lahey Health (Burlington, MA)
- …in utilization review and medical necessity activities Key responsibilities: Utilization review and inpatient clinical optimization: (include all ... Advisor will play an active role in optimizing healthcare resource utilization , ensuring quality, patient care, and managing valuable organizational resources. The… more
- Universal Health Services (Pembroke, MA)
- …LICSW, LMHC with current license in the State of Massachusetts. + Experience in Utilization Management either with a provider, insurance or HMO organization. + ... of obtaining certification and approval for payment in the inpatient and partial levels of hospitalization. The Utilization...Serves as the primary contact for all payors regarding utilization review and management issues. + Performs… more
- CenterWell (Boston, MA)
- …a part of our caring community and help us put health first** **National** ** Director of Transitional Care and High-Risk Patient Management ** The Director ... Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as… 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 ... 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 ... 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
- State of Massachusetts (Boston, MA)
- …seeking a motivated and committed Registered Nurse for the role of the Assistant Director of Nurses (ADON)/RN VI. This position Reports to the MBMHU Chief Operating ... Officer and the Director of Nursing and is responsible for activities at...for Performance Improvement, Joint Commission readiness activities of the inpatient units, and education. Acts in the interest of… more
- Beth Israel Lahey Health (Danvers, MA)
- …**Sign on bonus up to $3000 (pro-rated for part time)** The Executive Director of Addictions is responsible for the clinical, administrative and fiscal oversight of ... programs. Provides program leadership, development and direction for multiple inpatient detoxification, Transitional Support Services (TSS), Clinical Stabilization Services… more
- Fallon Health (Worcester, MA)
- …payment. + Maintains Personnel files for all SE Provider Staff & other VP/Medical Director direct + Provides support and calendar management for VP/Medical ... operational and administrative projects and provides ongoing support of the VP/Medical Director , and all Summit ElderCare Providers; this may include but is not… more
- Beth Israel Lahey Health (Wakefield, MA)
- …care setting to ensure continuous monitoring for quality improvement. + Refers quality/risk management cases to Manager, Medical Director and reports events per ... of population health and is responsible to ensure that quality, efficient care management services are provided to the BILHPN provider's risk populations. The Care… more
- Baystate Health (Springfield, MA)
- …provides leadership in strategic planning, program development, operations, and human resource management in partnership with the Chairman. The Director provides ... provision and improvement of quality patient care within the assigned departments. The director reports to the CNO, Vice President of Patient Care Services and… more
- State of Massachusetts (Taunton, MA)
- …as a member of a clinical team, develops incentive-based behavioral management programs, provides therapy, assessment, and psychological testing on a referral ... summary and not all inclusive)_/*: * Designs and implements incentive-based behavior management programs in collaboration with the patient and the treatment team to… more
- Beth Israel Lahey Health (Boston, MA)
- …maintains pharmacist staffing and vacation schedule *Collaborates with ambulatory infusion director & hematology/oncology inpatient manager to review and approve ... the Massachusetts Board of Registration in Pharmacy. 2. Collaborates with the Director of Pharmacy Operations and Pharmacy Leadership to develop and implement… 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
- Trinity Health (West Springfield, MA)
- …for 24-hour care delivery. 17.At the direction of the Medical Director reviews medical outcomes/statistical and utilization data, including reviewing ... time **Shift:** **Description:** POSITION PURPOSE Under the supervision of the medical director , the Primary Care physician (PCP) provides primary medical care to… 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
- Baystate Health (Springfield, MA)
- …nurse driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... **Licensed Practical Nurse, Inpatient Medical Unit** **Sign On Bonus Eligible!** Baystate...the unit has a close partnership with Physician Medical Director . + We provide supportive, individualized, and tailored orientation… 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
- Baystate Health (Springfield, MA)
- …nurse driven change projects including activity/mobility tool, acuity based assignments, capacity management workflow, and foley utilization . + The Manager is ... Center (BMC), a Magnet Hospital for Nursing Excellence is looking for a medical inpatient Registered Nurse to join our team in Springfield, MA. At Baystate Health,… more