- Commonwealth Care Alliance (Boston, MA)
- …skills to improve CCA enrollee outcomes by impacting care access and utilization , closing care quality gaps, and optimizing member connection to medical, behavioral ... an integral role in reducing high emergency department (ED) and inpatient utilization related to unmet social needs, including housing, food, community resources… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality assurance. +… more
- Veterans Affairs, Veterans Health Administration (West Roxbury, MA)
- …data from multiple services to produce comprehensive reports applicable to Peer Review , Utilization Review , and Performance Improvement. Promotes an ... Summary This Health System Specialist (Computerized Patient Record System Clinical Applications Coordinator)...responsible for collection of data from all appropriate sources, review and validation of the data collected, and preparation… more
- Datavant (Boston, MA)
- …tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and improve ... experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim...requirements of the role. The estimated base pay range per hour for this role is: $32-$45 USD To… more
- Beth Israel Lahey Health (Charlestown, MA)
- …to the accounts payable payment reporting and control function. Activities include: utilization of ERP system to: review daily payment/banking information loads, ... correct or release data into the ERP system upon verification, review payment forecasts, offset credit balances against applicable debits, review payment… more
- Evolent (Boston, MA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- Beth Israel Lahey Health (Burlington, MA)
- …training + Assists provider with minor procedures + Documents testing/results per practice protocol + Administers immunizations based on written provider orders ... and update as appropriate + Inserts the required forms per procedure and department protocol + Follows up with...and department protocol + Follows up with patient or specialist to ensure patient care plans since last appointment… more
