- Cardinal Health (Providence, RI)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- Beth Israel Lahey Health (Boston, MA)
- …informed. Represents the various service areas at assigned meetings. 7. Works closely with the Manager of Managed Care Department and shares oversight of the ... to evaluate effectiveness of interventions. Implements relevant information systems, such as managed care , insuring accuracy of data input and patient… more
- Atrius Health (Newton, MA)
- …welfare benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** *Senior Managed Care Analyst* **Location:** *Newton MA - ... Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients at 30 medical… more
- Indeed (Providence, RI)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- Molina Healthcare (Brockton, MA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Molina Healthcare (West Roxbury, MA)
- …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
- Humana (Providence, RI)
- …+ BSN or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see ... part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'… more
- Molina Healthcare (Boston, MA)
- …and cost-effective based on the severity of illness and the site of service. The Care Manager , LTSS provides support for care management/ care ... consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex...care , including at least 1 year experience in care management, managed care , and/or… more
- Athena Health Care Systems (Brockton, MA)
- …nurtured to allow you to grow within the company. As an RN Hospice Case Manager , you plan, organize, and direct hospice care . The professional nurse builds from ... facilitates the patient's efforts toward self-sufficiency and optional comfort care . + Acts as Case Manager when...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow… more
- Commonwealth Care Alliance (Boston, MA)
- …) **Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting + 2 or more years working in a clinical setting ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Athena Health Care Systems (Manville, RI)
- …daily living and facilitates the patient's efforts toward self-sufficiency and optional comfort care . + Acts as Case Manager when assigned by Clinical Supervisor ... individuals, regardless of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and… more
- State of Massachusetts (Boston, MA)
- …collaboration with staff from the Health Care Access Bureau and Bureau of Managed Care to advise the Commissioner about issues that may impact future ... citizens. *_About the Role:_* The Director of Pharmacy Benefit Manager Oversight operating within the Health Care ...market that have implications in health insurance mandates and managed care practices. * Manage staff working… more
- Beth Israel Lahey Health (Boston, MA)
- …expenses on Medicare Cost Report including mgmt of time studies. Liaisons with managed care to optimize contracts. Represent heart transplant with internal and ... process with internal teams for creation of charges, billing workflows and managed care contracting. (essential) 4. Maintains knowledge of regulatory… more
- Elevance Health (Providence, RI)
- …in acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. + MA RN ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management...Nurse Case Manager II** is responsible for care management within the scope of licensure for members… more
- CDM Smith (Boston, MA)
- …throughout the project planning, delivery, and closeout lifecycle. Senior Project Manager key performance indicators include revenue managed , profit delivered, ... CDM Smith currently has an exciting opportunity for a Senior Project Manager with previous experience managing municipal water services projects to join our… more
- Molina Healthcare (Norfolk, MA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- CDM Smith (Pawtucket, RI)
- …CDM Smith currently has a new opportunity for a Senior Project Manager with previous experience managing industrial water and/or wastewater projects to join ... Smith's mission by: * Managing and serving as the lead Project Manager on water/wastewater projects * Providing technical guidance, senior leadership, and mentoring… more
- State of Massachusetts (Boston, MA)
- …and dynamic individual for the position of Human Services Coordinator II (CYF Case Manager Supervisor) to join our Metro Boston Child, Youth, and Family team. The ... HSC-II will provide oversight of case- managed youth in DMH community services and statewide programs,...The HSC-II promotes DMH's philosophy of recovery, trauma informed care , person, youth and family centered choices and cultural… more
- Beth Israel Lahey Health (Needham, MA)
- …2. License required: Nursing License 3. 3-5 years related work experience required in Acute care or managed care setting with two years prior experience in ... & rotating holiday required) Job Summary: The RN Case Manager (CM) facilitates the coordination of care ...Case Manager (CM) facilitates the coordination of care for those patients admitted to medical, surgical services,… more
- CAI (Providence, RI)
- Case Manager , RN **Req number:** R6346 **Employment type:** Full...+ Minimum of 3 years of experience in Acute Care , Managed Care , or experience ... **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next...critical role in holistic assessment, planning, coordination, and monitoring care to optimize member health outcomes while advocating for… more