- CVS Health (Boston, MA)
- …regulations. The ideal candidate should possess the following skills: + Knowledge of Behavioral Health products, benefits and offerings + Understanding of Group ... a fast-paced environment + A passion for mental and behavioral health **What You Will Do** +...MHWB's Single Point of Contact for Market conduct exams, regulatory inquiries, and objections + Support the development and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dieticians, pharmacist, clinicians, medical ... for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health . This position… more
- Commonwealth Care Alliance (Brighton, MA)
- …are passionate about making a positive difference in the lives on individuals facing behavioral health challenges, we invite you to apply for this rewarding ... wraparound care for clients. + Works with the Nurse Manager (who may be employed by a partner organization)...+ Must be willing to work in a non-locked behavioral health setting. + Periodic need to… more
- Fallon Health (Milford, MA)
- …approves their care plan o Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager , Aging Service Access Point Geriatric ... and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...or her health needs, social needs or behavioral health needs o Collaborates with appropriate… more
- Beth Israel Lahey Health (Burlington, MA)
- …making a difference in people's lives.** Under the general direction of the Nurse Manager the Assistant Nurse Manager (ANM) practices within the Lahey Clinic ... full management responsibility in the absence of the Nurse Manager , which includes communicating policies, effectively recommending salary actions, evaluating… more
- Beth Israel Lahey Health (Burlington, MA)
- …(CNO) Associate Chief Nursing Officer (ACNO) and Nursing Directors, the Nurse Manager is responsible for day to day operations, practice development, communicating ... policies, and evaluates staff job performance.. The Nurse Manager works in collaboration with key stakeholder's and department leadership to coordinate the delivery… more
- Highmark Health (Boston, MA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job has primary ownership and oversight over a specified panel of members that range in ... health status/severity and clinical needs. The incumbent assesses ...and conducted in compliance with applicable business process requirements, regulatory requirements and accreditation standards. + Maintain current knowledge… more
- Highmark Health (Boston, MA)
- **Company :** Highmark 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...industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable… more
- Beth Israel Lahey Health (Burlington, MA)
- …job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse (RN) ... Case Manager for Hospital at Home Care Transitions coordinates utilization...clinical pathways. 12) Adheres to all insurance, contractual and regulatory requirements as mandated. 13) Works with Lahey Clinic… more
- Commonwealth Care Alliance (Boston, MA)
- …that researches, analyzes, develops and disseminates medical policies pertaining to medical and behavioral health services (eg procedures, DME, Part B drugs) ) ... and services addressing social determinants of health across all products and geographies in collaboration with...direct coverage of medical services are in compliance with regulatory , accreditation, and contractual requirements. The manager … more
- Commonwealth Care Alliance (Boston, MA)
- …to research, analyze, develop, and disseminate medical policies pertaining to medical and behavioral health services (eg, procedures, DME, Part B drugs) ) and ... the policies which direct coverage of medical services are in compliance with regulatory , accreditation, and contractual requirements. The program manager is a… more
- Beth Israel Lahey Health (Burlington, MA)
- …processes for determining appropriate patient admission status based on regulatory and reimbursement requirements of various commercial and government payers. ... data analysis, compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management. + Attends Mandatory Education programs… more
- Molina Healthcare (Boston, MA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... multidisciplinary integration and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Services & Supports for Molina… more
- State of Massachusetts (Boston, MA)
- …areas of policy focus for the OCA, (eg child welfare, juvenile justice, behavioral health , education), the OCA's work intentionally crosses systems and silos, ... affairs for the OCA. A Senior Policy & Implementation Manager plays a crucial rolein managing select policy and...the child welfare system, family support services, and/or children's behavioral health . _Commitment to Diversity_ __The OCA… more
- Fenway Health (Boston, MA)
- …Fenway Institute. This NIH-funded, multi-site observational cohort study collects longitudinal behavioral , clinical, and biological data from people living with HIV. ... (including PBMC isolation and cell pellet preparation) and oversee regulatory documentation, procurement, and study financial operations. The Senior Research… more
- Beth Israel Lahey Health (Burlington, MA)
- …Transplant Services is responsible for the strategic, financial, operational and regulatory oversight of the Division of Transplantation & Hepatobiliary Diseases, ... business management etc. 3. Manages staff including nurse/operations managers, quality manager , outreach manager , research coordinators and transplant financial… more
- Magellan Health Services (Hanscom AFB, MA)
- …personnel at child development centers, and consultation to installation command regarding behavioral health issues affecting children and youth. CYB counselors ... by the Office of Secretary of Defense (OSD) program manager . The CYB will flex schedule to respond to...Work Experience - Preferred Education - Required Master's - Behavioral Health Education - Preferred License and… more
- Beth Israel Lahey Health (Lynn, MA)
- …BayRidge Hospital was opened in 1996 providing inpatient, partial hospitalization, outpatient behavioral health and substance use treatment. Located in Lynn, MA, ... and 10 minutes from the Northshore. Reporting to the Manager of Admissions, the Admissions Clinician provides a clinical...clinical review of referrals for admission to the inpatient behavioral health units, clinical acceptance of admissions,… more
- Highmark Health (Boston, MA)
- …panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of ... various resources to assist members in achieving their personal health goals. Will work with providers to insure quality...and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create… more
- Highmark Health (Boston, MA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and… more