- 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. Office/Site Location:BostonRegular, Temporary, Per Diem:Per Diem… 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
- Evolent (Boston, MA)
- …contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… 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
- Beth Israel Lahey Health (Boston, MA)
- …patient delivery systems. Collects quality and variance data as well as utilization management . Utilizes clinical experiences and expertise in conjunction with ... to all patients who are referred to the case manager . Identifies case management needs in collaboration...care, dietetic, Elder Care and other clinical services. 4. Utilization Management /Managed Care: * Coordinates and organizes… 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
- Grant Thornton (Boston, MA)
- As a Healthcare Transaction Management Manager , you'll focus on buy-side and sell-side due diligence and transaction management engagements with large health ... teams + Provide expertise in the following: + Deal Management Office support + Standalone, one-time, and stranded cost...professional development + Meeting or exceeding targeted billing hours ( utilization ) + Other duties as assigned You have the… 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
- Covenant Health (Nashua, NH)
- …Experience + Minimum of five years broad clinical experience preferred + Case management and/or Utilization Management experience is preferred + ... + Annual goals are achieved. + Attends pertinent case management / utilization review programs to maintain current knowledge...MA / CMO and/or Director of Care Coordination or Manager Care Coordination/Case Management + Other duties… more
- Boehringer Ingelheim (Boston, MA)
- …an overview of our benefits please click here. **Description** The Strategic Account Manager will uncover opportunities for utilization of approved BI oncology ... in appropriate patient types. This individual will serve as strategic account management lead to engage Marketing, Specialty Market Access/HEOR, Health Systems, and… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …and category management best practices within the business (ie increased utilization of preferred suppliers, SoW optimization and the use of BuyEasy@Takeda etc.) ... is true to the best of my knowledge. **Job Description** The Regional Category Manager is responsible for the execution of the sub-categories Agency of Record (AOR)… 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
- ZOLL Medical Corporation (Boston, MA)
- …and sales support responsibilities. The ATM will work collaboratively with Territory Manager (s) to support sales activities and territory management tasks that ... and conferences, enabling prescribing entities to become self-sufficient through enrollment and utilization of ZOLL Patient Management (ZPM), with an added focus… more
- Highmark Health (Boston, MA)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- CenterWell (Marlborough, MA)
- …to sit on-site at our Marlborough, MA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
- Abbott (Boston, MA)
- …This includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management ... atherectomy devices. We currently have an opportunity available for an **Account Manager , Endovascular in Boston/South Rhode Island.** This role will be responsible… more
- Erickson Living (Peabody, MA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management /Safety (PI/RM/S) Committee ... Erickson Senior Living Join our team as the Clinical Manager is an active member of the clinical leadership...and processes in accordance with the Erickson Senior Living Management Policies and Procedures and nursing standards of practice.… more