- Beth Israel Lahey Health (Burlington, MA)
- …Hours:** 40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days ... 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
- Beth Israel Lahey Health (Burlington, MA)
- …0 **Work Shift:** Rotating (United States of America) The inpatient Case Manager assigned by nursing unit coordinates utilization review , discharge ... **Essential Duties & Responsibilities including but not limited to:** 1) Performs utilization review and discharge planning to inpatient admissions. 2) Applies… more
- Milford Regional Medical Center (Milford, MA)
- …of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria ... to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization management at… more
- Beth Israel Lahey Health (Cambridge, MA)
- …200-bed acute care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates ... discharge planning for MAH inpatient admissions. Inpatient Case Manager performance is evaluated using the...**Primary Responsibilities** (including but not limited to): 1. Performs utilization review and discharge planning to inpatient… more
- Commonwealth Care Alliance (Boston, MA)
- …UM team. + Participates in Team meetings for case review , workflow review and other relevant business related to utilization review process. + Works ... Important to Us:** Supervisor & The Team Leader reports to the UM Manager . The Team Leader provides management,oversight and mentorship to team members and ensures… more
- Baystate Health (Springfield, MA)
- …recognized leader in healthcare quality and safety, is searching for a **Full Time, RN Case Manager ** to join their **Inpatient Case Management Team.** The ... outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an...+ Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
- Spaulding Rehabilitation (East Sandwich, MA)
- Case Manager / Per Diem - East Sandwich...**Experience** Required + 5 years of related experience. + Case management, utilization review , or discharge ... or outpatient setting is required. Preferred + Health plan experience in utilization review and case management will be considered. **Licensure** Required +… more
- Beth Israel Lahey Health (Newburyport, MA)
- …you're not just taking a job, you're making a difference in people's lives.** **Job Description:** ** CASE MANAGER - Per diem** The Case Manager is ... an individual's health care needs. The goal of the case manager at Anna Jaques Hospital is...it services. Core components of this role involve concurrent utilization review and coordination and implementation of… more
- Brockton Hospital (Brockton, MA)
- …accepted criteria and guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as the primary liaison between ... of five years clinical experience in an acute care facility required. Prior experience in case management, utilization review or discharge planning required. more
- Amergis (Worcester, MA)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service ... and ongoingreassessments of the patient's status + Documents patient case information within a database system + Performs chart... information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly… more
- Milford Regional Medical Center (Milford, MA)
- …with other members of the healthcare team, the Point of Entry/Emergency Department Case Manager (POE/ED CM) is accountable for coordination and facilitation of ... with knowledge of current medical care technology and ancillary supports. Previous utilization review experience preferred Must be assertive with excellent… more
- Sevita (Lawrence, MA)
- …receipt from accounting staff; identify any discrepancies to accounting staff + Coordinate utilization with the Case Manager relative to program ... trained to provide individual assistance to each person we serve. Program Services Case Coordinator- Spanish Speaking Do you enjoy working in a medical/rehab setting… more
- South Middlesex Opportunity Council (Lowell, MA)
- …for all assigned properties as detailed below. Working closely with an assigned Case Manager to ensure that all property, municipal, regulatory and contractual ... inspections as required. + Attend regularly scheduled property performance review and status meetings. Develop and implement strategies to...in Hosing Court as needed. + Assist the assigned Case Manager as needed, to qualify potential… more
- CenterWell (Marlborough, MA)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and… more
- Brockton Hospital (Brockton, MA)
- …readmissions, improve HCAHPS, drive positive discharge outcomes and reduce LOS, and review ER utilization using proactive approaches to any barriers. The ... with the Manager of Care Coordination (or other designee) to review caseload and discuss barriers/challenges and review performance compared to current… more
- Beth Israel Lahey Health (Wakefield, MA)
- …engagement in healthy behavior. Working with the healthcare team, the Care Manager , RN monitors appropriate utilization of healthcare resources, promotes quality ... disability. The Care Manager , RN upholds the current standards of professional case management practice, and reports to the Manager of Care Management.… more
- Marriott (Boston, MA)
- …with Claims department regarding case management. + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... from case management to meet jurisdictional needs. Utilization Review + Provide initial clinical ...nurse + Certification as an occupational health nurse and/or case manager (or, progress toward same) required… more
- Elevance Health (Woburn, MA)
- …License in the state of Massachusetts as an LABA. _The BCBA Autism/BH Care Manager is primarily for conducting the clinical review process for ABA service ... (ABA) services only, and there is licensed staff supervision. Previous experience in case management/ utilization management with a broad range of experience with… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The instED Marketing Specialist Manager will be responsible for building and growing our brand with customers and prospects as ... well as maximizing the utilization of instED's in-home urgent care services by our...members, and providers). To achieve this the Marketing Specialist Manager will be responsible for all external communication and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …appropriate goals to promote optimal member outcomes. + Interpret and apply case management criteria, processes, policies, and regulatory standards to create, follow ... and appropriately document comprehensive care management plans. + Review medication list and educate members with complex pharmacy needs, and counsel on side effects… more