- Yale New Haven Health (East Providence, RI)
- …practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in ... Practice Evaluation: The RN evaluates owns' and others' nursing practice. Resource Utilization : The RN utilizes appropriate resources to plan provide and sustain… more
- Yale New Haven Health (Providence, RI)
- …and professionals, every day.Works under the supervision of the Nurse Manager /Clinical Coordinator. The Registered Nurse (RN) assesses, plans, implements, evaluates ... charge nurse.8. Meets performance expectations for Customer Service, Teamwork, Resource Utilization , and Staff and Self Development as outlined in performance… more
- Yale New Haven Health (Providence, RI)
- …and professionals, every day.Works Under The Supervision Of The Nurse Manager /Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates ... Charge Nurse.8. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance… more
- Yale New Haven Health (Providence, RI)
- …and professionals, every day.Works Under The Supervision Of The Nurse Manager /Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates ... Charge Nurse.8. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance… 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
- 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
- CVS Health (Woonsocket, RI)
- …Evaluates, designs, and implements new regulatory and/or business initiatives for Utilization Management from initiation through completion. + Partners ... anywhere in the United States* **Position Summary** The Sr. Manager of the UM Centers of Excellence (COE) is...and health plan operations and value creation methodologies including Utilization and Policy Management , Care Management… 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
- Beth Israel Lahey Health (Plymouth, MA)
- …its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management ** and ** Utilization Review** ... CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management ** This role is ideal for a … 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
- 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
- Iron Mountain (Boston, MA)
- …welcome your unique contributions? If so, let's start the conversation. **Senior Manager , Application Governance & Asset Management ** This role is responsible ... utilization , software license optimization, and efficient procurement. **Risk Management :** Working with Information Security and EIT Risk in identifying and… 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
- Clean Harbors (Norwell, MA)
- **Clean Harbors** is looking for a **Senior Asset Manager for Light Duty Vehicles** to be located out of **Norwell, MA** . The Senior Asset Manager for Light ... Duty Vehicles is responsible for the overall lifecycle management of a specific group of assets (such as type of vehicle or heavy equipment) that are utilized in… more
- CenterWell (Fall River, MA)
- …sit on-site at our** Fall River, MA **branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
- Beth Israel Lahey Health (Needham, MA)
- …practice model. **Job Description:** **Essential Responsibilities:** 1. Performs utilization management , care coordination, and discharge planning ... (every third weekend & rotating holiday required) Job Summary: The RN Case Manager (CM) facilitates the coordination of care for those patients admitted to medical,… more
- Colliers Engineering & Design (Boston, MA)
- … to lead our Civil/Site team in Boston, MA! The Department Manager is responsible for the professional, technical, management , marketing, administrative ... of work and the sharing of resources within the discipline, maximizing staff utilization . Reviews staff utilization regularly and promptly addresses staff not… more
- Amgen (Boston, MA)
- …playing a key role in establishing product demand and delivering comprehensive account management within a designated territory. You will serve a central point of ... patient care. As a SAM, you will drive product utilization while identifying and addressing the unique needs of...is a person with these qualifications. **Basic Qualifications (Account Manager - Level 4)** Bachelor's Degree and 3 years… more
