- 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
- 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
- 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
- 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 (Providence, RI)
- **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 (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
- Charter Care Health Partners (North Providence, RI)
- …of a specific patient population. Performs functions related to Patient Advocacy; Utilization Review; Resource Management ; Continuum of Care Management ... (Discharge planning) and Clinical Documentation Management . Collects data via utilization with Care Port to enhance the quality and cost effectiveness of patient… more
- ZOLL Medical Corporation (Providence, RI)
- …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
- Takeda Pharmaceuticals (Boston, MA)
- …and category management best practices within the business (ie increased utilization of preferred suppliers, SoW optimization and the use of BuyEasy@Takeda etc.) ... to the best of my knowledge. **Job Description** **SCOPE** The Regional Category Manager is responsible for the execution of the sub-category strategy in the region.… more
- Highmark Health (Providence, RI)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Abbott (Boston, MA)
- …This includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management ... atherectomy devices. We currently have an opportunity available for an **Account Manager , Endovascular in Boston/South Rhode Island.** This role will be responsible… more
- Federal Home Loan Bank of Boston (Boston, MA)
- …Summary This is a newly created position at the Bank. The Project Portfolio Manager will lead our project management team and oversee the project managers ... on project risk. . Resource Management o Collaborate with Bank Technology management to optimize resource utilization across the project portfolio and the… more
- Colliers Engineering & Design (Boston, MA)
- … to lead our Civil/Site team in Boston, MA! The Senior Project Manager is responsible for the professional, technical, management , marketing, administrative and ... of work and the sharing of resources within the discipline, maximizing staff utilization . Reviews staff utilization regularly and promptly addresses staff not… more
- Center For Health Information And Analysis (Boston, MA)
- …CHIA and be a driving force in health policy impact! We seek a Research Manager to help lead and manage our growing research projects within the dynamic Strategy and ... Research team. The Research Manager will work closely with the research team and...health care coverage and affordability, behavioral health, health care utilization , health care equity and social determinants of health.… more
- Sanofi Group (Providence, RI)
- **Job Title:** Regional Account Operations Manager , Northeast **Location:** Remote **About the Job** This position reports to the Regional Accounts Leader and is ... Groups to evaluate and influence the promotion of the placement and/or the utilization of our brands in alignment with brand strategy. **Access Execution:** + In… more
- Beth Israel Lahey Health (Boston, MA)
- …quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions ... making a difference in people's lives.** The RN Case Manager working in the Triad Model of Care Transitions...of efficient, high-quality care. This position ensures the appropriate utilization of clinical resources with a goal of a… more