- Tufts Medicine (Burlington, MA)
- …and smooth flow of communication and administrative support activities for the Utilization and Case Management departments. This position is well versed in insurance ... hire. 4. Three (3) years hospital/health care experience in the area of Utilization Management. 5. Basic Life Support Certification **OR** Obtain within three (3)… more
- Tufts Medicine (Lawrence, MA)
- …**Job Overview** Responsible for assisting the Manager of Patient Access, Utilization Review , Accounts Receivable and Medical Records/Health Information ... 2. Five (5) years of experience in accounts receivable and/or utilization review **Preferred Qualifications:** 1. Supervisory/management experience 2. Seven… more
- State of Massachusetts (Boston, MA)
- …Office of Housing and Livable Communities (EOHLC) is seeking a Facilities Management Specialist in the Division of Public Housing & Rental Assistance!_* *_ _* ... and reducing and preventing homelessness. *_OVERVIEW:_* The Facilities Management Specialist (FMS) providestechnicalassistance,performance-basedmonitoringoversight,andserveasprimaryEOHLCpointof contact on maintenance issues for a… more
- Beth Israel Lahey Health (Wakefield, MA)
- …in people's lives.** * Hybrid / Remote schedule * The Clinical Pharmacy Specialist - Population Health works collaboratively with other health care providers and ... patients, and guideline development and implementation. Additionally, the Clinical Pharmacy Specialist supports the safe, effective and efficient use of medications… more
- State of Massachusetts (Boston, MA)
- …Livable Communities (EOHLC) is seeking an Emergency Assistance (EA) Housing Search Specialist in the Division of Housing Stabilization!_* *_ _* *_AGENCY MISSION:_* ... to Massachusetts communities. *_OVERVIEW OF ROLE:_* The EA Housing Search Specialist assists family shelter providers (private non-profit agencies) across the… more
- Cambridge Health Alliance (Cambridge, MA)
- …team leader in multi-disciplinary team discussion regarding treatment planning, treatment review , quality assurance and utilization review ... Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry **Date Posted:** 09/24/2024 **Requisition...public healthcare system is seeking a per diem Clinical Specialist II (APRN) to join our team. CHA is… more
- Beth Israel Lahey Health (Burlington, MA)
- …in people's lives.** **Job Description:** **Position Summary:** The Clinical Pharmacy Specialist - Population Health works collaboratively with other health care ... patients, and guideline development and implementation. Additionally, the Clinical Pharmacy Specialist supports the safe, effective and efficient use of medication… more
- The Home for Little Wanderers (Dorchester, MA)
- …reports, documentation and billing in a timely manner. Ensure that documentation meets utilization review and quality assurance standards. + May be required to ... The Home for Little Wanderers is seeking a Permanency Specialist for the Youth Permanency Program. YPC is a...contract manager at DCF Central Office. The YPC Permanency Specialist engages the youth through regular in-person meetings and… more
- Lincoln Financial Group (Boston, MA)
- …and upcoming college graduates to join our Claims Organization as Claims Specialist supporting Group Protection division. Positions start dates will align to ... with Lincoln Financial Group. _Background Information:_ As a Claims Specialist , you will serve as the primary point of...information about the claims process including policy coverage and utilization , while recognizing what needs to be done to… more
- Beth Israel Lahey Health (Cambridge, MA)
- …people's lives.** Based out of (Burlington, MA.) Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific ... staff, nursing staff, and other healthcare professionals. The Clinical Pharmacy Specialist will participate in the development of clinical guidelines/protocols, new… more
- Beth Israel Lahey Health (Charlestown, MA)
- …to the accounts payable payment reporting and control function. Activities include: utilization of ERP system to: review daily payment/banking information loads, ... correct or release data into the ERP system upon verification, review payment forecasts, offset credit balances against applicable debits, review payment… more
- Beth Israel Lahey Health (Charlestown, MA)
- …include, utilization of our ERP system to: process/enter invoices/credits, review and resolve invoice coding and statement issues, monitor and respond to ... emails received in the general departmental mailbox (apx 500-700/daily), review /obtain approvals and release vouchers on payment hold, interact with Purchasing and… more
- Beth Israel Lahey Health (Winchester, MA)
- …issues to manager. + Assists Case Managers with all aspects of utilization review /discharge planning/performance improvement processes. + Functions as liaison ... + Travel Requirements: N/A **REPORTING RELATIONSHIPS:** + Reports to Supervisor , Utilization Management. + May be responsible for directing the workflow of others… 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
- Tufts Medicine (Boston, MA)
- …(BPS) credential in a related area of practice. 6. Experience in drug utilization review and analysis. **Minimum Qualifications of a Clinical Pharmacist** : ... either through residency training or prior job experience. 4. Experience in drug utilization review and analysis **Duties and Responsibilities** **:** The duties… more
- Prime Therapeutics (Boston, MA)
- …and make strategic recommendations regarding benefit plan design and utilization . **Responsbilities** + Manage annual renewal process, including analyze plan ... utilization , claims and health trends, model plan cost and...legislative changes impacting employee benefits and implement necessary adjustments; review and interpret plan documents to address compliance issues… more
- Beth Israel Lahey Health (Beverly, MA)
- …required forms per procedure and department protocol Follows up with patient or specialist to ensure patient care plans since last appointment were followed and ... results are available for physician review Confirms that lab and other ancillary tests are...data for identified patient populations Monitors patient progress by utilization of disease specific registries to proactively reach out… more
- State of Massachusetts (Boston, MA)
- …promoting coordination on various mental health topics and navigating systems. * Support utilization review processes: Support utilization review ... the direct supervision of the Regional Clinical Mental Health Specialist Manager, while also being overseen by the Director...to mental and behavioral health challenges. * Develop and review clinical plans: Create and review clinical… more
- Veterans Affairs, Veterans Health Administration (Jamaica Plain, MA)
- …data collection and analysis, entry of information into patient databases, chart review and drug information. This could include communicating with other services ... and compiles that data for interpretation by the clinical pharmacy specialist and/or interdisciplinary HBPC team. Additionally, the clinical pharmacy technician is… more
- 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 ... role in reducing high emergency department (ED) and inpatient utilization related to unmet social needs, including housing, food,...manner; promote and enforce the CCA compliance program + Review the Code of Conduct at least annually and… more