- Brooksby Village by Erickson Senior Living (Peabody, MA)
- …federal, state, and local, regulations and the facility's quality and service standardsManage occupancy development of Continuing Care ; actively market ... networking in the community with residents, families, discharge planners, social service workers, local business organizations, and other referral sourcesDevelop… more
- Beth Israel Lahey Health (Boston, MA)
- …patients and support staff to request, obtain, record, and attach primary and/or specialty care managed care referral and authorization requests for ... volume of referral and authorizations for multiple managed care payers. 3. Educates patients about... care payers. 3. Educates patients about the referral process, programs offered, and services provided… more
- Beth Israel Lahey Health (Westwood, MA)
- …BILH PCPs, patients and practice support staff to coordinate, and process all specialty care managed care referral authorization requests in compliance ... The Manager Care Coordinator initiates and process managed care insurance referral requests...include but are not limited to (POS) Point of Service Device, Health Wire Network, Aetna WebMD, NEHEN, HPHC… more
- Beth Israel Lahey Health (Boston, MA)
- …patients and support staff to request, obtain, record, and attach primary and/or specialty care managed care referral and authorization requests for ... volume of referral and authorizations for multiple managed care payers. 12. Educates patients about... care payers. 12. Educates patients about the referral process, programs offered, and services provided… more
- Fenway Health (Boston, MA)
- … managed care programs + Educate patients toward proactive use of managed care companies and referral authorization process + Inform providers and ... services provided for patients Monitor and update managed care member listings and verify membership...Meet with plan representative to learn updates or pertinent referral information Provide excellent customer service +… more
- Randstad US (Boston, MA)
- …The Director is responsible for the overall success of each assigned Managed In-House Agency/Studio (MIA). This includes managing, developing and partnering with ... cycle + Identify opportunities to provide enhanced and/or increased services for each End Client Company within and outside...assistance program and health advocacy + Health and dependent care flexible spending account + Metlife auto and home… more
- North Shore Community Health (Salem, MA)
- … care . With a strong commitment to excellence, NSCH provides: * Comprehensive primary care . * Dental services . * Behavioral health care . * Care ... * Pharmacy services . * Substance abuse disorder treatment. * Nurse care management. * Insurance enrollment assistance. NSCH operates service sites at… more
- Tufts Medicine (Burlington, MA)
- …meetings** **Job Overview** This position triages incoming requests from patients and primary care providers for managed care referrals for patients who ... and treatment they require. An organizational related support or service (administrative or clerical) role or a role that...processing the requests. 7. Maintains log of Community PCP referral requests for out of network care ;… more
- Beth Israel Lahey Health (Lawrence, MA)
- …+ Knowledge of commercial behavioral healthcare practices, evidenced based treatments, managed care principles, provider development and quality improvement ... care . **Responsibilities:** + Provides case consultation to emergency services clinicians and documentation review in various programs during designated shift… more
- Erickson Living (Hingham, MA)
- …and resolving issues regarding residents' care and safety + Developing referral networks within the community for available services + Educating residents ... Senior Living Linden Ponds is a beautiful 108-acre continuing care retirement community located just 24 miles from Boston...Responding to residents in need of psychosocial or supportive services , through direct referral or by the… more
- Highmark Health (Boston, MA)
- …effective utilization management strategies including: review of appropriateness of health care services , application of criteria to ensure appropriate resource ... and resolution of quality issues. Monitors and analyzes the delivery of health care services ; educates providers and members on a proactive basis; and… more
- Beth Israel Lahey Health (Lawrence, MA)
- …+ Knowledge of commercial behavioral healthcare practices, evidenced based treatments, managed care principles, provider development and quality improvement ... including those pertaining to patient rights, to ensure that exceptional customer service and patient care may be provided. 8.Utilizes organization's behavioral… more
- South Middlesex Opportunity Council (Framingham, MA)
- …Work with billing department to ensure authorizations are up to date + Attend level of care meetings with managed care entities and ACO's + Work with Program ... oversee a uniform model for delivery of coordinated and integrated community services , including but not limited to CSP-HI programs. Provide clinical and… more
- Spaulding Rehabilitation (Charlestown, MA)
- …Per Diem - ( 3290567 ) **Description** **Job Summary** Promote and market post-acute services to new and existing referral sources within a specified territory ... and/or account(s). Referral sources may include Acute Care Hospitals, Specialty Hospitals, Physicians and other clinical providers....in compliance with local, state and federal regulations. * Referral process is coordinated and managed to… more
- Advocates (Framingham, MA)
- …in collaboration with the team. + Develop and maintain a thorough knowledge of managed care and health insurance systems; provide other clinicians with ... managed care information and resources pertinent to...Provide information on community resources, treatment and providers, and referral services to individuals. + Assist with… more
- Beth Israel Lahey Health (Chestnut Hill, MA)
- …for specialty service and pre-certifications for patient's insurance and managed care plan. Collects required co-payments for multiple practices. Directs ... plan rules and process related policies for multiple insurance and managed care payers. Maintains current knowledge base of referral , level of care… more
- Erickson Living (Peabody, MA)
- …facility's quality and service standards + Manage occupancy development of Continuing Care ; actively market the continuum of care by networking in the ... community with residents, families, discharge planners, social service workers, local business organizations, and other referral sources + Develop an operating… more
- Advocates (Waltham, MA)
- …to the crises being managed . + Provide information on treatment and referral services as required. + Provide mental health and substance abuse triage ... consultation and problem resolution. + Develop and maintain a thorough knowledge of managed care and health insurance systems; provide other clinicians with … more
- Beth Israel Lahey Health (Boston, MA)
- …at assigned meetings. 7. Works closely with the Manager of Managed Care Department and shares oversight of the referral management staff. Implements Revenue ... to evaluate effectiveness of interventions. Implements relevant information systems, such as managed care , insuring accuracy of data input and patient… more
- Beth Israel Lahey Health (Lynn, MA)
- …the hospital, referral sources and payors + Maintain understanding of managed care contracts, insurance benefits, limitations, policies, procedures and forms ... assessments2) Knowledge of admission procedures and protocols3) Knowledge of managed care and other payors4) De-escalation/Restraint Management5) Effectively… more
