- Lawrence General Hospital (Lawrence, MA)
- The Utilization Review Specialist , under supervision and in collaboration with the Utilization Review Coordinator, Utilization Review Nurses, ... well as the integrated care team and supports the case management/ utilization review team on system-wide quality improvement/performance improvement initiatives.… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Position is eligible for our FLEX persona. The position serves as a Prepayment Review Coding Specialist within the Fraud Investigation & Prevention Unit ("FIP"). ... review processes with other departments to prevent inappropriate utilization of resources 11. Form recommendations regarding process improvements to eliminate… 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
- Pfizer (Boston, MA)
- …patients. **What You Will Achieve** The Rare Cardiac, Amyloidosis Multi-disciplinary Specialist (AMS), will target health care providers (HCPs), spanning multiple ... will report into the Area Business Manager (ABM). Amyloidosis Multi-disciplinary Specialist (AMS) will demonstrate strong business acumen, and an expert… more
- Beth Israel Lahey Health (Burlington, MA)
- …manager. . Assists Utilization Managers with all aspects of utilization review /discharge planning/performance improvement processes. . Functions as liaison ... line with payer expectations, contributing to favorable revenue cycle. The Operational Specialist position will have an impact on provider, patient, and staff… 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
- Lawrence General Hospital (Lawrence, MA)
- …Office product suite. Preferred: * Bachelor's degree * Case Management, Utilization Review or Prior Authorization experience * Bilingual English/Spanish ... Manager and Director of Integrated Care, the Infusion Clinical Authorization Specialist is responsible for ensuring all information for proper financial… more
- Beth Israel Lahey Health (Boston, MA)
- …Employees must reside in MA, NH, or RI. Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific clinical area, ... 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 (Westwood, MA)
- …you're making a difference in people's lives.** Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific clinical ... 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
- DuPont (Marlborough, MA)
- …(https://careers.dupont.com/us/en/whyjoinus) DuPont is a leading company in the full utilization of SAP's Environmental, Health, and Safety (EH&S) Product Safety ... specialty product businesses. The SAP EH&S Regulatory Data and Systems Senior Specialist position offers a challenging opportunity to gain exposure across the DuPont… more
- Novo Nordisk (Lowell, MA)
- …obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and sales strategies ... sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy + Analyze… more
- Lawrence General Hospital (Lawrence, MA)
- … Works collaboratively with the Complex Care Nurse Managers, Social Workers, and Utilization Review Nurses, in coordinating and providing care that is safe, ... timely, effective, efficient, equitable and client-centered. Assuming all administrative responsibilities within the admission and discharge planning, Perform other duties as needed and assigned by your supervisor. JOB RESPONSIBILITIES: + Perform the full… more
- Intermountain Health (Boston, MA)
- **Job Description:** The Pre-Access Prior Authorization RN provides timely review of authorization requests and/or review of denials to ensure medical necessity, ... of complex authorization requests using appropriate criteria, medical policy review and department expectations + Collaborate with various caregivers within… more
- Air Force Materiel Command (Hanscom AFB, MA)
- …telecommunications input into computing system operational design and proposal review . Implements telecommunication programs and special projects. Serves as a ... Knowledge of communication system and infrastructure installation standards, energy utilization , HVAC loading, and bonding/grounding. 8. Knowledge of deployment… 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
- Highmark Health (Boston, MA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to assure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- Beth Israel Lahey Health (Burlington, 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