- 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
- Tufts Medicine (Burlington, MA)
- …**Job Overview** The position provides day to day support and oversight to Utilization Review departments and UM vendor management. Responsible for compliance ... with CMS Conditions of Participation regarding Utilization Review and Discharge Planning including implementation and annual review of the Utilization … 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
- 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