- 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
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management /ReviewDepartment:Patient Services-Patient Care ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license as a… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for ... compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management . + Attends Mandatory Education programs required by… 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
- Children's Hospital Boston (Boston, MA)
- …+ Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license as a ... the concurrent review process for acute psychiatric care + Possessing experience in Utilization Management / Utilization Review + Demonstrating the ability to… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:**...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
- US Tech Solutions (Canton, MA)
- …all aspects of clinical decision making and support needed to perform utilization management , medical necessity determinations and benefit determinations using ... criteria through participation in the IMPAC. + Proactively identifies trends in Utilization Management applicable to the precertification and outpatient UM… more
- Elevance Health (Woburn, MA)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... integration, and ensures essential face-to-face onboarding and skill development. The ** Utilization Management Representative II** is responsible for managing… more
- Tufts Medicine (Boston, MA)
- …the best. Our nurses give it to them. Position/Job Title: Prof RN - Case Manager , 40 Hours Day Shift The nurses at Tufts Medical Center are integral to everything ... it to them. Position/Job Title: Prof RN - Case Manager , 40 Hours Day Shift **Job Profile** **Summary** This...Overview** This position is responsible and accountable for the management of care for an assigned patient population by… more
- Cambridge Health Alliance (Everett, MA)
- RN Case Manager - Inpatient Case Management Everett **Requisition Number:** 8001 **Location:** CHA Everett Hospital **Work Days:** 8-4:30pm including weekend ... Under the general supervision of the Director of Care Management , the RN Case Manager provides clinically-based...members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- Milford Regional Medical Center (Milford, MA)
- …Social Workers, Care Coordination Assistant, Post Hospital Transition Navigator, and Utilization Management functions. The MCM coordinates and facilitates the ... community with dignity, compassion and respect. Statement of Purpose: The Manager of Care Management (MCM) leads and directs all care management activities,… more
- Motion Recruitment Partners (Boston, MA)
- Sr. Mission Manager **Remote Only** Contract to Hire $70/hr - $100/hr **TG Federal is actively seeking a Sr. Mission Manager to join our remote team of ... Cybersecurity professionals.** **Summary:** The Sr. Mission Manager is a hybrid leadership role that combines the...operations team. + Track, manage, and report on labor utilization , forecasting, and burn rates to ensure alignment with… more
- Staples (Framingham, MA)
- …exceed P&L/budgets requirements + Optimize transportation spend through the strategic selection/ utilization of "best in class" carriers + Develop with support of ... of DOT mandated rules and regulations + Partner with Legal and Risk Management to address and mitigate business risk/ issues + Define project objectives, scope… more
- Molina Healthcare (Cambridge, MA)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
- Beth Israel Lahey Health (Wakefield, MA)
- …just taking a job, you're making a difference in people's lives.** The Care Manager , RN provides care management services to the BILHPN primary care physicians ... healthy behavior. Working with the healthcare team, the Care Manager , RN monitors appropriate utilization of healthcare..., RN upholds the current standards of professional case management practice, and reports to the Manager … more
- Beth Israel Lahey Health (Wakefield, MA)
- …management services are provided to the BILHPN provider's risk populations. The Care Manager , RN provides care management services to the BILHPN primary care ... healthy behavior. Working with the healthcare team, the Care Manager , RN monitors appropriate utilization of healthcare..., RN upholds the current standards of professional case management practice, and reports to the Manager … more
- Beth Israel Lahey Health (Boston, MA)
- …Center. Compile and evaluate requests and make recommendations on efficient space utilization in the Medical Center. Investigate and recommend the purchase and ... transition to a new space management / asset management software. Supervise and provide...system. Coordinate, analyze and report on space needs and utilization . Perform in-depth analysis, test fit scenarios, and develop… more
- Grifols Shared Services North America, Inc (Boston, MA)
- …specified "Account List" of Health Systems designed to increase the adoption and utilization of the Grifols Bleeding Management product portfolio. The KAM's ... role in the successful launch of a new Bleeding Management product within the Grifols Biopharma portfolio. The KAM...provide any necessary support to the responsible National Account Manager (NAM) in the execution of the contracting process… more
- Aveanna Healthcare (Worcester, MA)
- … + Driving EVV Utilization + Driving Electronic documentation (EMR) utilization + Compliance tracking + Unemployment claim management + Worker compensation ... Home Health Branch Manager ApplyRefer a FriendBack Job Details Requisition #:...Details Requisition #: 205607 Location: Worcester, MA 01606 Category: Management Salary: $60,000.00 per year Position Details FIND YOURSELF… more
- Savers | Value Village (Worcester, MA)
- **Job Title: Store Manager ** **Who we are:** As one of the largest for-profit thrift operators in the United States, Canada and Australia for value priced pre-owned ... peace of mind. + Programs to stop smoking, diabetes management coaching, and on demand care options. + A...a constant focus on growing the business through full utilization of every OK, followed by increasing OK volume… more