- Commonwealth Care Alliance (Boston, MA)
- …care services,procedures, and facilities under the provisions of CCA's benefits plan.The Manager , Utilization Management is responsible for overseeing and ... CMS compliance standards in the area of service decisions and organizational determinations.The Manager , Utilization Management reports to the Director of… more
- Commonwealth Care Alliance (Boston, MA)
- …required. + CCM (Certified Case Manager ) preferred + 1 to 2 years Utilization Management experience required. + 2 or more years working in a clinical ... under the provisions of CCA's benefits plan. The Nurse Utilization Management (UM) Reviewer is responsible for...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Children's Hospital Boston (Boston, MA)
- …Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Office/Site Location:BostonRegular, Temporary, Per Diem:Per Diem ... 74825BRJob Posting Title:RN Case Manager , Inpatient & Ambulatory (Per Diem)Department:Patient Services-Patient Care… more
- Evolent Health (Boston, MA)
- …others. **Collaboration Opportunities:** + The Manager , Client Services oversees daily utilization management and directs the medical care of our members on ... plans and serves in a supporting role to the Director, Intake and Utilization Management Operations. + This individual will not only lead a production team but… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical ... and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets CMS… more
- Evolent Health (Boston, MA)
- …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 an efficient and...department. The UM Lead, in collaboration with the UM Manager and Director, ensures compliance with all regulatory standards… more
- Wolters Kluwer (Waltham, MA)
- …activities, branding & tailoring, pulling reports, and customer training. **Ongoing Utilization Management ** + Oversee customer utilization and ... quality and effective care. **ESSENTIAL DUTIES & RESPONSIBILITIES** The **Customer Success Manager - National Accounts** plays a lead role in managing and driving… more
- Cambridge Health Alliance (Malden, MA)
- Manager , Ambulatory Capacity Management Apply Refer a Friend Back **Date Posted:** 10/04/2024 **Requisition Number:** 8544 **Location:** Commerce Place **Work ... with, the Executive Director, Provider Operations and Strategy (ED/POS), the Manager , Ambulatory Capacity Management is responsible for the centralized… more
- Beth Israel Lahey Health (Milton, MA)
- …acute care or managed care setting + 2 years prior experience in Case Management , preferred (Discharge Planning and Utilization Review + Current knowledge of ... you're making a difference in people's lives.** The Case Management Department provides case management services to...**Beth Israel Deaconess Milton** is seeking a full-time **Case Manager ** . The Case Manager works as… more
- Point32Health (Canton, MA)
- …with the interdisciplinary care team, to improve member outcomes (ie, Utilization Management , Medical Director, pharmacy, community health workers, dementia ... management , population health and wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager possesses… more
- Elevance Health (Woburn, MA)
- **Account Service Manager Sr - Pharmacy Account Management ** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will ... Travels to worksite and other locations as necessary. The **Account Service Manager Sr** is responsible for providing highly advanced account management … more
- Quickbase (Boston, MA)
- Job Title : Sr. Manager , Professional Services Operations Department : Professional Services Location : Hybrid, 2 days a week in Boston Office Manager : Rupali ... Sawhney, Senior Director, Professional Services Summary Description of Position The Manager of Professional Services Operations will be detail-oriented and highly… more
- Novo Nordisk (Lexington, MA)
- …to senior management and other key stakeholders + Use space utilization data to forecast future workspace and lab needs, proactively identifying opportunities ... medicines for patients. The Position The Space Planner Project Manager is responsible for managing phased growth, major move...sites as needed and will focus on data-driven space management and long-term planning. As the company transitions to… more
- Brockton Hospital (Brockton, MA)
- …continuous, comprehensive, familya€centered, coordinated, compassionate, and culturally effective. The Care Manager position is an integral member of the PCMH team ... of high risk/high cost patients * Providing Transitional Care Management (TCM) services for eligible patients as they transition...will be measured via specific quality outcomes. The Care Manager will work in the primary care setting in… more
- Clean Harbors (Norwell, MA)
- Clean Harbors is looking to hire an **Asset Manager ** that will be responsible for the overall lifecycle management of a specific group of assets (such as type ... are utilized in the Company's Service or Facilities operations. Lifecycle management oversight includes: asset acquisition and justification, asset deployment, asset… more
- Burns & McDonnell (Newton, MA)
- …, Program Manager as well as internal and external executive management as required. + Collaborate with engineering team to establish the development and ... **Description** The Construction Project Manager supports the Engineer Procure Construct (EPC) Project Manager or Program Manager to oversee day-to-day… more
- Sanofi Group (Cambridge, MA)
- …duplicate discounts], and product-specific rebate conditions [e.g. formulary placement, utilization management criteria, competitor market landscape]). + Support ... Customer. + Review, interpret, and assess specialty product reimbursement and utilization management criteria against pre-defined contracting objectives. +… more
- Pfizer (Cambridge, MA)
- …major role in delivery of care across US Hospitals. The Senior Manager , Institutional Customer Marketing, Sterile Injectables (SI) Portfolio is responsible for ... involve partnering cross functionally with key stakeholders in Portfolio, Sales, Account Management , Medical, Legal, Regulatory and PGS, among others, as well as… more
- Takeda Pharmaceuticals (Boston, MA)
- …and category management best practices within the business (ie increased utilization of preferred suppliers, SoW optimization and the use of BuyEasy@Takeda etc.) ... to the best of my knowledge. **Job Description** **SCOPE** The Regional Category Manager is responsible for the execution of the sub-category strategy in the region.… more
- Eastern Bank (Lynn, MA)
- The Fraud Operations Manager is responsible for Operations division evaluation and execution of drivers that support the strategy of fraud detection and prevention, ... overall efficiency, and technology advancements. **Overall Management Responsibilities:** Management for all fraud operations functions: Designs, implements, and… more