- 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
- 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
- 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 ... Maximum $96,137.00 - $110,510.00 - $130,728.00 The Hospital Case Manager is a registered nurse responsible for the coordination...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- Beth Israel Lahey Health (Beverly, MA)
- …functions include concurrent and retrospective review to ensure appropriate utilization , assessment, prevention of denials , and coordination of discharge ... options. They are required to follow specific criteria sets to ensure regulatory compliance. They coordinate safe discharge plans between the health care delivery team, patients, families, insurers, and continuing care agencies. **Education/Experience:**… more
- Beth Israel Lahey Health (Beverly, MA)
- …functions include concurrent and retrospective review to ensure appropriate utilization , assessment, prevention of denials , and coordination of discharge ... options. They are required to follow specific criteria sets to ensure regulatory compliance. They coordinate safe discharge plans between the health care delivery team, patients, families, insurers, and continuing care agencies. **Education/Experience:**… more
- Beth Israel Lahey Health (Newburyport, MA)
- …functions include concurrent and retrospective review to assure appropriate utilization , assessment, prevention of denials and coordination of discharge ... options. They are required to follow specific criteria sets to assure regulatory compliance. They coordinate safe discharge plans between the health care delivery team, patients, families, insurers and continuing care agencies. **Education/Experience:** 1.… more