- 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
- 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
- Commonwealth Care Alliance (Boston, MA)
- …Work collaboratively with internal departments-including Clinical Operations, Contracting, Network Management , Utilization Management , and Business ... and improvement efforts. Through reporting, data analysis, and partnership management , the LTSS Program Manager ensures that...& Language (nice to have):** + Familiarity with care management and utilization management systems… more
- Red River (Boston, MA)
- **Position Summary:** The Manager , Residency Services reports to Director of Professional Services. Responsibilities include: Identifying new Residency Services ... further our Corporate Mission, Values and Objectives. Red River's Residency Services Manager will be responsible for our residents' growth and operational … more
- Commonwealth Care Alliance (Boston, MA)
- …member experience. - Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... does not have direct reports. Essential Duties & Responsibilities: Provider Relationship Management - Serve as the primary relationship manager and point… more
- Commonwealth Care Alliance (Boston, MA)
- …delegated partnerships programs, working with clinical community partners responsible for care management and utilization management across CCA's One Care ... Knowledge, Skills, Abilities & Language (nice to have): - Familiarity with care management and utilization management systems and workflows. - Experience… more
- Commonwealth Care Alliance (Boston, MA)
- …- Reporting to a member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible for all nursing and nursing ... support functions within the practice, the Primary Care Nursing Manager will collaborate closely with other members of the... will collaborate closely with other members of the management team. This role is full-time on site in… more
- Stratasys (Waltham, MA)
- Customer Success Manager Location: Waltham, MA, US Job ID: 54474 Category: Sales and Business development **Stratasys is a world leader in 3D printing!** ... to manufacturing and supply chains, and improve patient care. **Software Customer Success Manager ** . This role is pivotal in ensuring our customers achieve success… more
- Parexel (Boston, MA)
- …of quality worldwide meeting venues . Working knowledge of virtual meeting management and platforms . Experience working with Cvent platform a plus **Client ... relationship management ** . Proactively manages Client expectations and ensures delivery...Completes/approves project related expense claims **Metrics for success** . Utilization /billability target . Contribution to achievement of project, team,… more
- Endo International (Worcester, MA)
- …and maintain call objectives for geography with minimal consultation with Area Sales Manager (ASM) to assure proper portfolio balance and planned actions. + Develop ... maintain performance guidelines for the following metrics: call activity, appropriate utilization of samples, Quarterly Business Plan update. + Incorporate and… more
- Commonwealth Care Alliance (Boston, MA)
- … management and team-building skills - Telehealth - Practice Manager experience - Bilingual or Multilingual Strongly Preferred: Spanish **Compensation ... providing primary care, palliative care and community intensive care management to a specific panel of high risk and...of Care Delivery. programs. Under the supervision of the Manager of Patient Access Operations and in direct partnership… more
- Commonwealth Care Alliance (Boston, MA)
- …and provider relationship management tools. - Understanding of claims operations, utilization management , and quality programs as they relate to provider ... engagement, delegation partnerships, provider services, contracting, quality, compliance, medical management , and analytics teams to advance provider network operations,… more
- Commonwealth Care Alliance (Boston, MA)
- …Community Health Workers (CHWs) are key supports to interdisciplinary care management teams and complement and support enrollees' needs, goals, and preferences. ... skills to improve CCA enrollee outcomes by impacting care access and utilization , closing care quality gaps, and optimizing member connection to medical, behavioral… more
- Paycom Online (Providence, RI)
- …and accurate completion of the project. **RESPONSIBILITIES** **Workload & Project Management :** + Defines a detailed implementation plan for all customers which ... + Achieving results by organizing time effectively and utilizing self- management habits that lead to increased productivity. + Managing...** + Actively drives the company vision through the utilization of the Paycom solution + Easily adapts to… more
- 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
- Commonwealth Care Alliance (Boston, MA)
- …member experience. * Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... does not have direct reports. Essential Duties & Responsibilities: Provider Relationship Management * Serve as the primary relationship manager and point… more
- University Medicine (Providence, RI)
- SUMMARY: Reporting to the Manager of Case Management , the nurse case manager is responsible for providing comprehensive screenings, assessment, care ... to the right level of care and decrease unnecessary utilization . The nurse case manager is an...identify those patients who may benefit from high-risk case management (eg rising risk, frequent ED utilization ).… more
- State of Massachusetts (Boston, MA)
- …appropriate to inform the Division's various audiences. The Director of Pharmacy Benefit Manager Oversight is a senior management level position that reports to ... Division of Insurance values inclusiveness and diversity within their employee and management teams. Within our community we strive to create and maintain working… more
- Charter Care Health Partners (North Providence, RI)
- …of a specific patient population. Performs functions related to Patient Advocacy; Utilization Review; Resource Management ; Continuum of Care Management ... (Discharge planning) and Clinical Documentation Management . Collects data via utilization with Care Port to enhance the quality and cost effectiveness of patient… more
- Charter Care Health Partners (North Providence, RI)
- …of a specific patient population. Performs functions related to Patient Advocacy; Utilization Review; Resource Management ; Continuum of Care Management ... and Clinical Documentation Management . Collects data via utilization with Care Port to enhance the quality and...Center Case Management (CCM) (R) board certification or Accredited Case Manager (ACM (TM) ) is highly… more
