- Pine Street Inn (Boston, MA)
- …and Pine Street-s leadership team, engage management and staff in evolving behavioral health programs in accordance with the agency-s strategic plan + ... Government Relations management , insure that the Inn-s Behavioral Health Programs comply with all regulatory...integration of services for guests in shelter and maximize utilization of stabilization and other clinical services + Create… more
- Advocates (Randolph, MA)
- …someone who is creative, flexible and excited about bringing mental and behavioral health support to individuals with developmental disabilities! This salaried ... Behavioral Treatment Specialists. + Provides for the fiscal management of the program and assures the proper ...management of the program and assures the proper utilization of the agency's financial resources. + Responds to… more
- State of Massachusetts (Boston, MA)
- …efforts to address our work with children, youth and families impacted by mental and behavioral health challenges. Their primary role is to act as a consultant ... community that services children and families with mental and behavioral health challenges. The daily roles and...DCF field staff and promoting coordination on various mental health topics and navigating systems. * Support utilization… more
- CenterWell (Boston, MA)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as… more
- Highmark Health (Boston, MA)
- …account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and case/ disease management ... information to improve individual outcomes as an adjunct to health coaching. If acting in the capacity as a...review. + Assist in the development and implementation of utilization management programs including but not limited… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …both urgent and continuous medical, substance use disorder and behavioral health care. + Deliver low-threshold, high-quality case management in various ... severe mental illness, and a history of high healthcare utilization . The CM/TC is responsible for connecting highly marginalized,...case management for our Street Team/MGH Clinic Behavioral Health Community Partners teams. + Orient… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations to serve ... to ensure unconditionally equitable and dignified access to the highest quality health care for all individuals and families experiencing homelessness in greater… more
- Commonwealth Care Alliance (Boston, MA)
- …, closing of care quality gaps, and optimizing member connection to medical, behavioral health , and substance use disorder resources. CHW IIs play an ... Workers (CHWs) are key members of interdisciplinary care management teams and complement and support each enrollee's needs,...Primary Care Provider (PCP) or specialty care providers (eg behavioral health clinician). + CHW IIs utilize… more
- Highmark Health (Boston, MA)
- …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...clinical care is being provided. **Preferred** + Certification in utilization management or a related field +… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations to serve ... medication couriering + Facilitate referrals to BHCHP and external services for both behavioral health and medical care, document referrals and interactions with… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …outreach, enrollment, and ongoing case management for one of our Behavioral Health Community Partners teams. + Identify appropriate services to address ... from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations to serve… more
- Highmark Health (Boston, MA)
- …Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Commonwealth Care Alliance (Boston, MA)
- …optimizing enrollees' formal and informal supports, and promoting engagement with medical, behavioral health , and substance use providers as appropriate. CHW Is ... Workers (CHWs) are key members of interdisciplinary care management teams and complement and support each enrollee's needs,...Primary Care Provider (PCP) or specialty care providers (eg behavioral health clinician). + CHW Is utilize… more
- Tufts Medicine (Burlington, MA)
- …services to patients. In addition, this role focuses on performing the following Medical/ Behavioral Health duties: Provides behavioral evaluation services to ... impede progress. 22. Makes recommendations to the team regarding patient/family care and management . 23. Assists health care team to assist patient/family level… more
- Highmark Health (Boston, MA)
- …for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is ... including verification of benefit eligibility. Build cases in the utilization management system. + Use knowledge of...0 - 1 year of experience working in the Health Insurance Industry **LICENSES AND CERTIFICATIONS** **Required** + None… more
- The Home for Little Wanderers (Dorchester, MA)
- …meet certain medical criteria. This program is part of the Massachusetts Children's Behavioral Health Initiative (CBHI). Our two CSA programs together serve ... systems and experience advocating for family members who are involved with behavioral health systems + Must maintain certification in the Massachusetts… more
- WellSense (Boston, MA)
- …agencies + Assists with staff training and mentoring. + Refers cases to Social Care Management , Behavioral Health Care Management , and Community ... team (both internal and external) including providers, our clinical vendor partners ( behavioral health , pharmacy, etc.) and community/ State agencies to increase… more
- Beth Israel Lahey Health (Danvers, MA)
- …clinical, administrative and fiscal oversight of Addiction Services within BILH Behavioral Services. Ensures quality of care and contract compliance across licensed ... attain the highest level of quality standards across all Behavioral Services programs. **Responsibilities:** + Promotes programmatic efficiencies and effectiveness.… more
- Highmark Health (Boston, MA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- Fenway Health (Boston, MA)
- …consistent with the care philosophy of patient-centeredness, non-judgmental, harm reduction, behavioral health integration, and team-based care. The nurse serves ... Job Type Full-time Description As a Registered Nurse (RN) at Fenway Health you will provide compassionate, evidence-based, and efficient care to individuals,… more