- Beth Israel Lahey Health (Plymouth, MA)
- …you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding UR… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard ... denials . They identify and implement initiatives to manage utilization trends, collaborating with the hospital's discharge planning case managers, healthcare… more
- Beth Israel Lahey Health (Burlington, MA)
- …collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. Continuously monitors processes for opportunities ... the context of other Revenue Cycle functions such as Denials & Appeals, Patient Access, Authorization Management & ...Responsibilities** _including but not limited to:_ + Ensures that Utilization Review nurses are consistently recommending the… more
- Beth Israel Lahey Health (Plymouth, MA)
- …care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care ... the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established… more
- Beth Israel Lahey Health (Plymouth, MA)
- …care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care ... the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established… more
- Children's Hospital Boston (Boston, MA)
- … review process for acute psychiatric care + Possessing experience in Utilization Management/ Utilization Review + Demonstrating the ability to integrate ... denials . They identify and implement initiatives to manage utilization trends, collaborating with the hospital's discharge planning case managers, healthcare… more
- Robert Half Finance & Accounting (Shrewsbury, MA)
- Description The Revenue Cycle Manager is responsible for overseeing and optimizing the end-to-end revenue cycle processes, a Federally Qualified Health Center (FQHC) ... standards, KPIs, and SLAs related to vendor performance. * Review and escalate vendor issues that impact cash flow...challenges and/or breakdowns in the revenue cycle process causing denials or delayed payments. * Perform ongoing trend analysis… more
- Baystate Health (Springfield, MA)
- …and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers ... The **RN Hospital Case Manager ** is a registered nurse responsible for the...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- Baystate Health (Springfield, MA)
- **SUMMARY DESCRIPTION** Under the direction of the Program Manager or Director of the Service Line, the Scheduler-2 is responsible for detailed and complex schedules ... Surgical Services, Risk Management, Patient Financial Services, Information Technology, Denials , and Capacity Management teams to ensure coordination of services… more