- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
- Children's Hospital Boston (Boston, MA)
- 79378BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... two years of employment. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Office/Site Location:BostonRegular,… more
- Beth Israel Lahey Health (Boston, MA)
- …review of the clinical course to all patients who are referred to the case manager . Identifies case management needs in collaboration with the ... Patient Care Management: * Screens all patients referred to Case Manager for appropriate management and plan...trends and analyze reports. * Provides data for the Utilization Review Committee. 7. Fiscal: Under the… more
- Covenant Health (Nashua, NH)
- …are attended /documented. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge ... care and enhancing quality, cost-effective clinical outcomes. The RN Case Manager works closely with, and delegates...Minimum of five years broad clinical experience preferred + Case management and/or Utilization Management experience is… more
- Beth Israel Lahey Health (Beverly, MA)
- …team, you're not just taking a job, you're making a difference in people's lives.** Case Manager RN **Job Description:** ** Case Manager RN** **Position ... care givers, and families. Their functions include concurrent and retrospective review to assure appropriate utilization , assessment, prevention of denials… more
- Cardinal Health (Boston, MA)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient ... develop and execute effective solutions. + Provide guidance and training to junior case managers on best practices in case management, patient interaction, and… more
- State of Massachusetts (Quincy, MA)
- …quality assurance initiatives.*__* * Refer suspected abuse and fraudulent members to the program manager or designee for case review .*__* * In the absence ... is seeking qualified applicants for the position of*Clinical Pharmacy Manager *. The Clinical Pharmacy Manager functions as...as a liaison to EOHHS sister agencies, the Drug Utilization Review Program, pharmacy providers, and the… more
- Elevance Health (Woburn, MA)
- …supervision. **Preferred Skills, Capabilities, & Experiences:** + Previous experience in case management/ utilization management with a broad range of experience ... insightful analytics to improve the delivery of care._ **Behavioral Health Care Manager I** **Location:** This position is open to any **licensed** candidate, with… more
- Cisco (Boston, MA)
- …and deliver exceptional value to our customers. Your Impact As a Customer Success Manager , you play a crucial role in helping our customers successfully adopt and ... You are proactive and strategic, with a passion for driving software utilization to accelerate business outcomes. You excel at crafting and implementing Technical… more
- GAF (Cambridge, MA)
- …this roof, we protect what matters most. **Team Summary** The Maintenance Excellence Manager is a key member of the Corporate Reliability & Maintenance team and ... with the site Planners/Schedulers/Supervisors and can tailor site-specific needs on a case -by- case basis. + Works with supporting organizations on a unified… more
- Riverside Community Care (Lynnfield, MA)
- …and administrative oversight for assigned clinicians, including case consultation/ review , ongoing clinical supervision, utilization review /clinical ... Riverside Community Care Love what you do! Clinical Team Manager - Lynnfield Outpatient Riverside seeks a Clinical Team Manager for the Lynnfield Outpatient… more
- Nestle (Sudbury, MA)
- …+ Risk Assessment and Elimination - Leads the effective implementation and utilization of risk assessment and risk prediction processes across sites to ensure ... recurrence are effectively implemented while also ensuring an effective injury case management process is fully implemented, well understood, and functioning as… more
- Highmark Health (Boston, MA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
- State of Massachusetts (Lowell, MA)
- …whose belief system may be predicated on values incongruent with those of the Case Manager Supervisor. . Ability to supervise and evaluate performance of staff. ... services are provided to clients. . Participates in the Case Management Record Review Committee and follows-up...monthly basis. . Meets monthly with assigned programs to review clients' utilization of identified services and… more
- Beth Israel Lahey Health (Burlington, MA)
- …Maintains inventory spreadsheet for ordering purposes of non-Pyxis product 13) Audits daily case equipment and supply utilization sheets to ensure accuracy of ... and in conjunction with the appropriate clinical personnel, (ie department nurse manager or clinical manager ), coordinates and manages the procurement of… more
- Beth Israel Lahey Health (Beverly, MA)
- …Improvement and CQI issues as well as to unsafe working conditions. Notifies manager of concerns. Participates in unit based QI activities and is familiar with ... appointment were followed and results are available for physician review Confirms that lab and other ancillary tests are...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. Reviews, manages… more
- Tufts Medicine (Burlington, MA)
- …cooperation with multiple revenue cycle and hospital departments, such as Coding, Utilization Management (UM), Case Management, Quality and Physician advisors ... and evaluate the CDI program. This includes management of case mix index (CMI), length of stay (LOS), Observed...and leaders. The Director oversees the manager and clinical documentation specialists (CDSs) in planning, implementing… more
- State of Massachusetts (Boston, MA)
- …methods, emergency preparednessandresponse,workorderprioritization,capitalitems, feasibilityassessmentsofinternalforceaccount work, review of operating budgets for ... and management staff to ensure the highest possible performance. Duties also include a review of LHA Annual Plans and assistance to LHAs in utilizing the Capital… more
- WTW (Boston, MA)
- …of response and report any issues or impact to timeline proactively to Project Manager + Complete initial review of carrier responses for parity projects + ... Health analytics experience preferred + Understanding of health plan utilization / case management processes, network management, credentialing, quality… more
- Evolent (Boston, MA)
- …Oncology clinical Q&As for provider portal, prior authorizations, lists, regimens, scope diagnoses, case review and related activities. + Review of Carepro ... value- based care and initiatives within pathway, policy, and beyond utilization management solutions. + Introduce innovative initiatives supported with evidence and… more