- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... 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)
- …collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. Continuously monitors processes for opportunities ... Duties & Responsibilities** _including but not limited to:_ + Ensures that Utilization Review nurses are consistently recommending the appropriate admission… 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
- Sevita (Marlborough, 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. **Bilingual (Mandarin) Case Coordinator** **- Adult Day Health** Location: Aging Well Adult Day Care… more
- Tufts Medicine (Burlington, MA)
- …**Job Overview** The position provides day to day support and oversight to Utilization Review departments and UM vendor management. The UM Operations ... is responsible for compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning including implementation and annual … 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
- Molina Healthcare (Lowell, MA)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… 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
- 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
- Beth Israel Lahey Health (Burlington, MA)
- …Maintains inventory spreadsheet for ordering purposes of non-Pyxis product 12) Audits daily case equipment and supply utilization sheets to ensure accuracy of ... provide a detailed monthly report on any overage. 3) Review /modify min/max inventory levels. 4) Audits inventory levels not...Reviews inventory cost to budget and works with clinical manager on variances. 7) Acts as contact person for… more
- US Foods (Worcester, MA)
- …through the following: consultative services to aid customers through improved utilization of the fresh categories; SOUS training; conducting product demonstrations ... and menu ideas prioritized for top penetration opportunities to achieve Market/Area case growth objectives for category, as well as, realize Exclusive Brand (EB)… more
- Beth Israel Lahey Health (Burlington, 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...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. + Reviews,… more
- Beth Israel Lahey Health (Woburn, 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 o Confirms that lab and other ancillary tests...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. o Reviews,… more