- 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
- 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
- Commonwealth Care Alliance (Boston, MA)
- …Work collaboratively with internal departments-including Clinical Operations, Contracting, Network Management , Utilization Management , and Business ... and improvement efforts. Through reporting, data analysis, and partnership management , the LTSS Program Manager ensures that...& Language (nice to have):** + Familiarity with care management and utilization management systems… more
- Commonwealth Care Alliance (Boston, MA)
- …delegated partnerships programs, working with clinical community partners responsible for care management and utilization management across CCA's One Care ... Knowledge, Skills, Abilities & Language (nice to have): - Familiarity with care management and utilization management systems and workflows. - Experience… more
- Battelle Memorial Institute (Norwell, MA)
- …polyfluoroalkyl substances (PFAS). We are currently seeking a **PFAS Chemistry Program Manager ** (Chemist III) to join our expanding team. This position will provide ... more market sector (eg, semiconductor, oil & gas, waste management ). **Preferred Qualifications** + Consideration will be placed on...programs for equal treatment of all staff and full utilization of all qualified employees at all levels within… more
- CORT (Norwood, MA)
- …in the Outlet Center(s) & Showrooms to increase revenue and inventory utilization + Leads inventory management efforts, controls, warehousing, and delivery ... **Overview** CORT Furniture rental is hiring a full-time Assistant District General Manager (ADGM). The ADGM works with the District General Manager to plan,… more
- Commonwealth Care Alliance (Boston, MA)
- …- Reporting to a member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible for all nursing and nursing ... support functions within the practice, the Primary Care Nursing Manager will collaborate closely with other members of the... will collaborate closely with other members of the management team. This role is full-time on site in… more
- Qualus (Westwood, MA)
- **Position Overview** **Power your future with Qualus** as a Senior Project Manager in our Program Management organization. We are seeking a Senior Project ... Manager to provide planning, management , and overall execution of a portfolio of power...budgets, and schedules. + Analyzes project performance and resource utilization . + Identifies potential out of scope work. +… more
- Commonwealth Care Alliance (Boston, MA)
- …APC is responsible for the oversight of clinical care delivery and complex care management within the CIC interdisciplinary team. The Manager , Clinical APC is ... programing is responsible for providing care delivery and care management to a specific panel of high risk and...plans. + Accountable for quality and financial outcomes, service utilization , targeted case mix and productivity levels of APCs… more
- Commonwealth Care Alliance (Boston, MA)
- …and help deliver healthcare of the 21st century! The Data Science Manager at instED is a clinical/business-facing and technical-facing role that collaborates with ... derive key insights from advanced analytics. The Data Science Manager will focus on the data extraction and processing,...predictive models which help instED identify ER and in-patient utilization patterns as well as service needs of high-risk… more
- Commonwealth Care Alliance (Boston, MA)
- …- Strong management and team-building skills - Telehealth - Practice Manager experience - Bilingual or Multilingual Strongly Preferred: Spanish EEO is The Law ... providing primary care, palliative care and community intensive care management to a specific panel of high risk and...of Care Delivery. programs. Under the supervision of the Manager of Patient Access Operations and in direct partnership… more
- Commonwealth Care Alliance (Boston, MA)
- …Community Health Workers (CHWs) are key supports to interdisciplinary care management teams and complement and support enrollees' needs, goals, and preferences. ... skills to improve CCA enrollee outcomes by impacting care access and utilization , closing care quality gaps, and optimizing member connection to medical, behavioral… more
- Paycom Online (Providence, RI)
- …and accurate completion of the project. **RESPONSIBILITIES** **Workload & Project Management :** + Defines a detailed implementation plan for all customers which ... + Achieving results by organizing time effectively and utilizing self- management habits that lead to increased productivity. + Managing...** + Actively drives the company vision through the utilization of the Paycom solution + Easily adapts to… more
- 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
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
- Beth Israel Lahey Health (Plymouth, MA)
- …its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management ** and ** Utilization Review** ... CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management ** This role is ideal for a … more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... + Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager … more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... + Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager … more
- Beth Israel Lahey Health (Plymouth, MA)
- …patient care status. This role is structured around four major functions + Utilization Management + Care Coordination + Discharge Planning + Preventing ... 3) Decreasing unit cost, 4) reducing readmissions. **Duties/Responsibilities:** **A. Utilization Management ** Performs review of anticipated admissions utilizing… more
- Iron Mountain (Boston, MA)
- …welcome your unique contributions? If so, let's start the conversation. **Senior Manager , Application Governance & Asset Management ** This role is responsible ... utilization , software license optimization, and efficient procurement. **Risk Management :** Working with Information Security and EIT Risk in identifying and… more
