- 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
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... two years of employment. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Office/Site Location:BostonRegular,… 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
- Commonwealth Care Alliance (Boston, MA)
- …Knowledge, Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and retrospective ... facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing...for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring...RN **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** +… more
- Children's Hospital Boston (Boston, MA)
- …psychiatric nursing experience preferred. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Licensure/ ... 80501BRJob Posting Title:Behavioral Health RN Case Manager - 20hrsDepartment:Patient Services-Patient Care...process for acute psychiatric care + Possessing experience in Utilization Management/ Utilization Review + Demonstrating… more
- Cardinal Health (Boston, MA)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient ... develop and execute effective solutions. + Provide guidance and training to junior case managers on best practices in case management, patient interaction, and… more
- Beth Israel Lahey Health (Beverly, MA)
- …care givers, and families. Their functions include concurrent and retrospective review to assure appropriate utilization , assessment, prevention of denials ... taking a job, you're making a difference in people's lives.** **Job Description:** **Position Summary:** Case managers serve as the care coordinators for patients,… 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
- 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. **Job… 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
- Molina Healthcare (Boston, 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
- Highmark Health (Boston, MA)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case … more
- Federal Home Loan Bank of Boston (Boston, MA)
- Project Portfolio Manager Location Boston Apply Now (https://phh.tbe.taleo.net/phh01/ats/careers/v2/applyRequisition?org=FHLBBOSTON&cws=38&rid=435) Project Portfolio ... Summary This is a newly created position at the Bank. The Project Portfolio Manager will lead our project management team and oversee the project managers over… more
- Cisco (Boston, MA)
- …and deliver exceptional value to our customers. Your Impact As a Customer Success Manager , you play a crucial role in helping our customers successfully adopt and ... You are proactive and strategic, with a passion for driving software utilization to accelerate business outcomes. You excel at crafting and implementing Technical… more
- Riverside Community Care (Lynnfield, MA)
- …and administrative oversight for assigned clinicians, including case consultation/ review , ongoing clinical supervision, utilization review /clinical ... Riverside Community Care Love what you do! Clinical Team Manager - Lynnfield Outpatient Riverside seeks a Clinical Team Manager for the Lynnfield Outpatient… more
- Bright Horizons (Newton, MA)
- The Talent Acquisition Optimization Manager is responsible for driving the efficiency and effectiveness of the talent acquisition process through the implementation ... Managing the execution of system enhancements, including planning, development, and review of required training and communication materials. + Training and Change… more
- Evolent (Boston, MA)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical...and findings with matrixed Physician Business Manager . + Provides medical direction to… more
- Highmark Health (Boston, MA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
- Beth Israel Lahey Health (Boston, MA)
- …completing all required fields, communicating to the appropriate personnel, and entering the case into the OR Manager system, utilizing all proper codes for ... Charge and Anesthesia, but is ultimately responsible to the OR Nurse Manager . **Job Description:** PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS: 1. Exemplifies the… more