- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality assurance. +… more
- State of Massachusetts (Boston, MA)
- …workdays may be performed remotely.* Responsibilities include: . Conduct ongoing on-site compliance review (a minimum of two per week) at ALRs located throughout ... a qualified, skilled, and motivated candidate to fill the*Certification Specialist *position within AGE's Assisted Living Certification Unit. The Certification … more
- Oracle (Boston, MA)
- …stays. + Knowledge of third-party payor rules and regulations. + 2-3 years of Utilization Review experience in a healthcare setting preferred; 1-2 years of ... college and AHIMA Certified RHIT credentials preferred + Certification in Utilization Review , case management, and healthcare quality preferred… more
- Oracle (Boston, MA)
- …Manager and the roles within the pods (eg, Business Analyst, Integration Specialist , QA, etc.) and contribute to strategic planning, direction, and goal setting ... procedures, contractual budgets, providing expert-level insight on the development, utilization , and revision of contractual agreements. + Maintains customer… more
- Datavant (Boston, MA)
- …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +...requirements of the role. The estimated base pay range per hour for this role is: $22-$45 USD To… 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
- Beth Israel Lahey Health (Burlington, MA)
- …training + Assists provider with minor procedures + Documents testing/results per practice protocol + Administers immunizations based on written provider orders ... and update as appropriate + Inserts the required forms per procedure and department protocol + Follows up with...and department protocol + Follows up with patient or specialist to ensure patient care plans since last appointment… more
- Beth Israel Lahey Health (Peabody, MA)
- …training o Assists provider with minor procedures o Documents testing/results per practice protocol o Administers immunizations based on written provider orders ... completeness before appointment and update as appropriate. Inserts the required forms per procedure and department protocol Follows up with patient or specialist… more
- Beth Israel Lahey Health (Peabody, MA)
- …training + Assists provider with minor procedures + Documents testing/results per practice protocol + Administers immunizations based on written provider orders ... and update as appropriate + Inserts the required forms per procedure and department protocol + Follows up with...and department protocol + Follows up with patient or specialist to ensure patient care plans since last appointment… more
- Beth Israel Lahey Health (Peabody, MA)
- …training o Assists provider with minor procedures o Documents testing/results per practice protocol o Administers immunizations based on written provider orders ... completeness before appointment and update as appropriate Inserts the required forms per procedure and department protocol Follows up with patient or specialist… more