- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management /ReviewDepartment:Patient Services-Patient Care ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license as a… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for ... compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management . + Attends Mandatory Education programs required by… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare? Bring your true colors to blue. The Role:The Medical Clinical Program Manager will focus on utilization management compliance and audit ... 's (HMM) and delegate's compliance with the applicable NCQA utilization management standards and state and federal...of HMM Quality and Compliance team, the Clinical Program Manager works through the influence as an individual contributor… more
- Children's Hospital Boston (Boston, MA)
- …+ Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license as a ... the concurrent review process for acute psychiatric care + Possessing experience in Utilization Management / Utilization Review + Demonstrating the ability to… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:**...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
- Performance Food Group (Whitinsville, MA)
- …Coordinates pick planning in conjunction with the Warehouse Manager . + Utilization of Company's warehouse management system and other technologies available ... candidate should possess:** + Strong knowledge of warehouse procedures, inventory management , and material handling equipment. + Experience with inventory … more
- Cambridge Health Alliance (Everett, MA)
- RN Case Manager - Inpatient Case Management Everett **Requisition Number:** 8001 **Location:** CHA Everett Hospital **Work Days:** 8-4:30pm including weekend ... Under the general supervision of the Director of Care Management , the RN Case Manager provides clinically-based...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Milford Regional Medical Center (Milford, MA)
- …Social Workers, Care Coordination Assistant, Post Hospital Transition Navigator, and Utilization Management functions. The MCM coordinates and facilitates the ... community with dignity, compassion and respect. Statement of Purpose: The Manager of Care Management (MCM) leads and directs all care management activities,… more
- Staples (Framingham, MA)
- …exceed P&L/budgets requirements + Optimize transportation spend through the strategic selection/ utilization of "best in class" carriers + Develop with support of ... of DOT mandated rules and regulations + Partner with Legal and Risk Management to address and mitigate business risk/ issues + Define project objectives, scope… more
- Molina Healthcare (Boston, MA)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
- Cherry Bekaert (Boston, MA)
- **Description** We have a new opportunity to join our Advisory Resource Management team as we continue to add integral capabilities and tools to support Cherry ... Bekaert's (https://www.cbh.com/) growth. As a Resource Manager you are collaborating with executive and staff-level professionals in this highly visible role. As a… more
- Beth Israel Lahey Health (Wakefield, MA)
- …just taking a job, you're making a difference in people's lives.** The Care Manager , RN provides care management services to the BILHPN primary care physicians ... healthy behavior. Working with the healthcare team, the Care Manager , RN monitors appropriate utilization of healthcare..., RN upholds the current standards of professional case management practice, and reports to the Manager … more
- Beth Israel Lahey Health (Wakefield, MA)
- …management services are provided to the BILHPN provider's risk populations. The Care Manager , RN provides care management services to the BILHPN primary care ... healthy behavior. Working with the healthcare team, the Care Manager , RN monitors appropriate utilization of healthcare..., RN upholds the current standards of professional case management practice, and reports to the Manager … more
- Beth Israel Lahey Health (Boston, MA)
- …Center. Compile and evaluate requests and make recommendations on efficient space utilization in the Medical Center. Investigate and recommend the purchase and ... transition to a new space management / asset management software. Supervise and provide...system. Coordinate, analyze and report on space needs and utilization . Perform in-depth analysis, test fit scenarios, and develop… more
- Grifols Shared Services North America, Inc (Boston, MA)
- …specified "Account List" of Health Systems designed to increase the adoption and utilization of the Grifols Bleeding Management product portfolio. The KAM's ... role in the successful launch of a new Bleeding Management product within the Grifols Biopharma portfolio. The KAM...provide any necessary support to the responsible National Account Manager (NAM) in the execution of the contracting process… more
- Aveanna Healthcare (Worcester, MA)
- … + Driving EVV Utilization + Driving Electronic documentation (EMR) utilization + Compliance tracking + Unemployment claim management + Worker compensation ... Home Health Branch Manager ApplyRefer a FriendBack Job Details Requisition #:...Details Requisition #: 205607 Location: Worcester, MA 01606 Category: Management Salary: $60,000.00 per year Position Details FIND YOURSELF… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …and category management best practices within the business (ie increased utilization of preferred suppliers, SoW optimization and the use of BuyEasy@Takeda etc.) ... is true to the best of my knowledge. **Job Description** The Regional Category Manager is responsible for the execution of the sub-categories Agency of Record (AOR)… more
- ZOLL Medical Corporation (Boston, MA)
- …and sales support responsibilities. The ATM will work collaboratively with Territory Manager (s) to support sales activities and territory management tasks that ... and conferences, enabling prescribing entities to become self-sufficient through enrollment and utilization of ZOLL Patient Management (ZPM), with an added focus… more