- Beth Israel Lahey Health (Beverly, MA)
- …trends the data as it relates to denials and reports that data to the Manager of Case Management for review. The Clinical Denials Specialist utilizes nursing ... retroactive and concurrent denials. This position reports directly to the Manager of Case Management. **Responsibilities** Concurrently reviews all medical… more
- Molina Healthcare (Boston, MA)
- …and supports (LTSS), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... We are looking for a candidate with a MA RN licensure and case management experience. Candidates...individuals with substance use disorders. **Preferred Qualifications** * Certified Case Manager (CCM). * Experience working with… more
- Beth Israel Lahey Health (Plymouth, MA)
- …people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth Israel Deaconess ... Plymouth and Barnstable counties. Our Nutrition Services Team consists of registered and licensed dietitians who provide expert nutritional interventions to improve… more
- Beth Israel Lahey Health (Plymouth, MA)
- …denial prevention strategies * Integrate clinical and reimbursement knowledge for optimal outcomes ** RN Case Manager - Emergency Department UR & Discharge ... plays a vital role in ensuring seamless, patient-centered care. ** RN - Utilization Review** This role is ideal for...Proficiency in InterQual required + CCM, ACM, or other case management certification preferred or in progress ** Manager… more