- Evolent Health (Boston, MA)
- …results, and collaborating with others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for assisting the ... UM Manager in supervising the operational productivity of the Utilization Management nurses by implementing and maintaining...flow of information through the UM department. The UM Lead , in collaboration with the UM Manager and Director,… more
- Fresenius Medical Center (Medford, MA)
- …As a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our employees are our ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- Point32Health (Canton, MA)
- …perform the job** **Education, Certification and Licensure** + Master's degree preferred. + RN ( Registered Nurse ) with unrestricted MA license preferred. + ... at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director, Utilization Management is responsible for directing, leading, and… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical ... regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting strategic direction,… more
- Elevance Health (Woburn, MA)
- ** RN Hospital Bill Audit/Appeal Lead ** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** RN Hospital Audit/Appeal Lead ** is responsible for leading a team… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …As an integral member of the Project SHINE clinical care management team the Registered Nurse ( RN ) Care Manager (CM) will have the opportunity to make ... front line of patient care, to the managers who lead and guide our staff, to the many support...living with HIV on topics related to chronic disease management , adherence, STI screening and safe sex. + Demonstrate… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …range planning and determining staffing needs. + Assists Home Care Manager/Residential Nurse manager to monitor utilization and processes for stocking Nursing ... front line of patient care, to the managers who lead and guide our staff, to the many support...(IDT), providing assistance with oversight of health aide and nurse scheduling, and providing direct supervision of health aides.… more
- Elevance Health (Woburn, MA)
- Nurse Audit Lead - Carelon Payment Integrity **Location:** The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a ... Integrity, is determined to recover, eliminate, and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead ** is responsible for leading a team of… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …+ Highly collaborative and team-oriented + Clinical experience (ie Registered Nurse , Social Worker) required + Management / supervisory experience preferred ... homelessness. Enhanced coordination between clinical services, legal resources, case management , program development (including fundraising), quality improvement, language access/interpretation,… more
- Veterans Affairs, Veterans Health Administration (Boston, MA)
- …include administrative staff for review of eligibility, authorizations and scheduling etc., Registered Nurses ( RN 's) for care coordination and if applicable ... recruitment will result in the hiring of one of the following disciplines: Nurse Practitioner or Physician Assistant. All interested Nurse Practitioners must… more
- Elevance Health (Boston, MA)
- …managing the clinical operations department. Manages the delivery of quality care management , clinical utilization and referral services. **Location:** Remote - ... unrestricted license in a mental health field as an RN , PhD, LCSW (as applicable by state law and...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more