- Children's Hospital Boston (Boston, MA)
- 76071BRJob Posting Title:RN Case Manager , Utilization Review , Case Management UM/UR (24 hrs)Department:Patient Services-Patient Care ... OperationsAutoReqId:76071BRStatus:Part-TimeStandard Hours per Week:24 Job Posting Category:NursingJob Posting Description:The Utilization Review Nurse will be responsible for:… more
- Beth Israel Lahey Health (Burlington, MA)
- …Hours:** 40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days ... 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
- Milford Regional Medical Center (Milford, MA)
- …of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria ... to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization management at… more
- Amergis (South Weymouth, MA)
- **PLEASE ONLY APPLY IF YOU ARE A REGISTERED NURSE** CASE MANAGER RN Location: Weymouth, MA Duration: 13 weeks Start Date: 7/22 Hours: 40 hours/week Shifts: Day ... M-F, every other weekend rotation Requirements: + 2+ years Case Manager RN experience + Must have...for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers… more
- Beth Israel Lahey Health (Beverly, MA)
- …team, you're not just taking a job, you're making a difference in people's lives.** Case Manager RN **Job Description:** ** Case Manager RN** **Position ... care givers, and families. Their functions include concurrent and retrospective review to assure appropriate utilization , assessment, prevention of denials… more
- Milford Regional Medical Center (Milford, MA)
- …with other members of the healthcare team, the Point of Entry/Emergency Department Case Manager (POE/ED CM) is accountable for coordination and facilitation of ... with knowledge of current medical care technology and ancillary supports. Previous utilization review experience preferred Must be assertive with excellent… more
- Sedgwick (Boston, MA)
- …**PRIMARY PURPOSE** : To ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients by ... to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Clinical Manager **This manager will have to be...at client locations; to provide expertise in client specific case management and utilization review … more
- Beth Israel Lahey Health (Charlestown, MA)
- …engagement in healthy behavior. Working with the healthcare team, the Care Manager , RN monitors appropriate utilization of healthcare resources, promotes quality ... disability. The Care Manager , RN upholds the current standards of professional case management practice, and reports to the Manager of Care Management.… more
- Marriott (Boston, MA)
- …with Claims department regarding case management. + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... from case management to meet jurisdictional needs. ** Utilization Review ** + Provide initial clinical ...nurse + Certification as an occupational health nurse and/or case manager (or, progress toward same) required… more
- Tufts Medicine (Burlington, MA)
- …issues and other assigned subjects. 4.Provides timely and effective consultation to case management/ utilization review team members, including assessment of ... on quality, ethical, regulatory, and/or financial topics related to patient care, utilization management/ review , case management, and revenue cycle… more
- Humana (Boston, MA)
- …and integrated care needs for those with autism + Prior experience with Utilization Review , Utilization Management, Peer Reviews and/or Quality Management ... appropriate treatment, care, or services for ACD participants. + Review ABA TPs for policy compliance + Review...Business to improve policy which may relate to better case management outcomes, improved utilization management, prevention… more
- Highmark Health (Boston, MA)
- …per week position that includes weekend coverage. This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case … more
- Sedgwick (Boston, MA)
- …claims requiring extensive skills/experience; and to interact with expense bill reviewers, utilization review nurses, and claims staff to resolve problems and/or ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Bill Review Team Lead **PRIMARY PURPOSE** : To supervise expense bill reviewers in… more
- Beth Israel Lahey Health (Cambridge, MA)
- …a job, you're making a difference in people's lives.** The Supply Chain Manager for Perioperative Services and Procedural Areas reports to the Director of Supply ... contract management, standardization and consolidation processes, inventory flow and management and utilization analysis of the OR, GI and Cath Lab supply inventory.… more
- DuPont (Marlborough, MA)
- …- Provide marketing support to product stewardship team for periodic product risk review . **Interaction:** Product Manager will interact on a frequent basis with ... the DuPont Electronics & Industrial Business has a Product Manager opening in Marlborough, MA. As Product manager...- Establish costing models for new product introductions. - Review / approve sample requests in appropriate database. Follow… more
- The Home for Little Wanderers (Somerville, MA)
- …documentation, and billing in a timely manner. Ensure that documentation meets utilization review and quality assurance standards. + Continuously communicate ... This may include extensive telephone contact and scheduling and attending case conference meetings. Facilitate communication between various providers. + Plan,… more
- Deloitte (Boston, MA)
- …phrases like "global effective tax rate reduction" and "efficient global cash utilization " peak your interest? Do you enjoy providing international compliance and ... a career in Deloitte's International Tax Services practice. What You'll Do As a Manager , you will work within an engagement team and draw on experience in accounting… more
- ThermoFisher Scientific (Waltham, MA)
- …teams, identifying security gaps, and tracking implementation of mitigating actions. + Utilization of security case management system to supervise and maintain ... Conditions** Office **Job Description** **Protective Services Investigator and Risk Management Senior Manager ** **Based in Waltham, MA** When you are part of the… more
- State of Massachusetts (Boston, MA)
- …promoting coordination on various mental health topics and navigating systems. * Support utilization review processes: Support utilization review ... of this position will be Regionally\Area Based. The Regional Mental Health Specialist Manager will provide direct supervision for this position with the Director of… more
- Humana (Boston, MA)
- …(5) plus years of experience in clinical areas such as: Utilization / Case Management, Claims Resolution, Contract/Market Management, and/or Healthcare ... of UM Processes + Assist in the development, iteration, launch and utilization of tools/tracking mechanisms + Assist in the identification, creation, value… more