- Commonwealth Care Alliance (Boston, MA)
- …skills to improve CCA enrollee outcomes by impacting care access and utilization , closing care quality gaps, and optimizing member connection to medical, behavioral ... an integral role in reducing high emergency department (ED) and inpatient utilization related to unmet social needs, including housing, food, community resources… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality assurance. +… more
- Veterans Affairs, Veterans Health Administration (West Roxbury, MA)
- …data from multiple services to produce comprehensive reports applicable to Peer Review , Utilization Review , and Performance Improvement. Promotes an ... Summary This Health System Specialist (Computerized Patient Record System Clinical Applications Coordinator)...responsible for collection of data from all appropriate sources, review and validation of the data collected, and preparation… more
- Datavant (Boston, MA)
- …tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and improve ... experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim...requirements of the role. The estimated base pay range per hour for this role is: $32-$45 USD To… more
- PPL Corporation (Providence, RI)
- …today. Overview **NOTE: This is a hybrid position requiring on-site presence three days per week at one of our local offices, located in Allentown, PA (Lehigh ... and decision-making process. This position performs complex tasks such as review of reporting materials, presentation of reporting materials, data updates from… more
- Evolent (Boston, MA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
