- 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 (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… 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
- Tufts Medicine (Burlington, MA)
- …with the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization ... to Utilization Review departments and UM vendor management . The UM Operations Manager is responsible...the Utilization Management Plan and assisting… 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 (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... + Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager … more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... + Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager … more
- Baystate Health (Springfield, MA)
- …needs of each project. By forecasting future resource requirements and optimizing utilization , the Resource Manager helps Baystate Health meet its mission ... Monitor utilization and target hours against project plans Cost management : Contribute to project budgeting by ensuring efficient resource allocation and… more
- Beth Israel Lahey Health (Plymouth, MA)
- …patient care status. This role is structured around four major functions + Utilization Management + Care Coordination + Discharge Planning + Preventing ... 3) Decreasing unit cost, 4) reducing readmissions. **Duties/Responsibilities:** **A. Utilization Management ** Performs review of anticipated admissions utilizing… more
- C&W Services (Boston, MA)
- **Job Title** Sr. Manager , Change Management **Job Description Summary** We are seeking a highly skilled and dynamic Sr. Manager , Change Management to ... sustain continuous change. **Job Description** **Key Responsibilities:** + **Change Management Strategy** : Crafts and executes comprehensive change management… 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
- Baystate Health (Springfield, MA)
- … management as outlined in the evidence based practice guidelines Uses Utilization Analysis / Management principles, insures that patient's site of care ... **Patient Placement Bed Manager ** **FULL TIME - Days** **7A-7P** **Every 3rd...system based on clinical relevance, with integration of care management skills to support organizational fiscal goals. Supports 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
- Boehringer Ingelheim (Worcester, 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
- 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