- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
- Beth Israel Lahey Health (Burlington, MA)
- …collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. Continuously monitors processes for opportunities ... Duties & Responsibilities** _including but not limited to:_ + Ensures that Utilization Review nurses are consistently recommending the appropriate admission… more
- Molina Healthcare (Lowell, MA)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- Lawrence General Hospital (Lawrence, MA)
- …referrals and facilitates appropriate discharge plans. + Works in conjunction with Utilization Review Nurse, Social Worker and Clinical Care Leader to ... As the Complex Care Nurse Manager provides evidence-based assessments, tools, information, and resources...setting with discharge planning, continuing care, care management, and utilization review . + Five years clinical nursing… more
- Elevance Health (Manchester, NH)
- …services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with ... essential face-to-face onboarding and skill development. The **Behavioral Health Care Manager II** is responsible for managing psychiatric and substance abuse or… more
- Nestle (Sudbury, MA)
- …+ Risk Assessment and Elimination - Leads the effective implementation and utilization of risk assessment and risk prediction processes across sites to ensure ... recurrence are effectively implemented while also ensuring an effective injury case management process is fully implemented, well understood, and functioning as… more
- Tufts Medicine (Burlington, MA)
- …cooperation with multiple revenue cycle and hospital departments, such as Coding, Utilization Management (UM), Case Management, Quality and Physician advisors ... and evaluate the CDI program. This includes management of case mix index (CMI), length of stay (LOS), Observed...and leaders. The Director oversees the manager and clinical documentation specialists (CDSs) in planning, implementing… more
- CDM Smith (Manchester, NH)
- …global corporate teams with accounting- and tax-related matters. * Monitor and review deliverables from local finance teams to ensure timeliness, accuracy, and ... and control activities, with an emphasis on streamlining them by utilization of Oracle Enterprise Management Software solutions, such as Financial Consolidation… more
- Beth Israel Lahey Health (Burlington, MA)
- …Improvement and CQI issues as well as to unsafe working conditions. Notifies manager of concerns. Participates in unit based QI activities and is familiar with ... appointment were followed and results are available for physician review + Confirms that lab and other ancillary tests...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. + Reviews,… more