- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and med/surg experience… more
- Beth Israel Lahey Health (Burlington, MA)
- …difference in people's lives.** This position is on-site. **Job Description:** The Utilization Analyst works with physicians, the payers and inpatient case ... management team to validate the medical necessity of the...necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these… more
- Beth Israel Lahey Health (Wakefield, MA)
- …as independently. Experience working with the chronic, complex and/or behavioral health population in a physician management service organization is highly ... Managed Care Organizations as well as Community Partners for Behavioral Health and Long Term Services and...her with needed services, resources, and opportunities. Utilizing medical management techniques the Social Worker supports the ACO in… more
- Covenant Health (Nashua, NH)
- …Case Manager works closely with, and delegates care to, the High-Risk Social Worker/ Behavioral Health Clinician because of assessment and determination of social ... to receive services. + Delegates cases to High-Risk Social Worker/ Behavioral Health Clinician based on assessment including...of five years broad clinical experience preferred + Case management and/or Utilization Management experience… more
- Beth Israel Lahey Health (Wakefield, MA)
- …as independently. Experience working with the chronic, complex and/or behavioral health population in a physician management service organization is highly ... Managed Care Organizations as well as Community Partners for Behavioral Health and Long Term Services and...her with needed services, resources, and opportunities. Utilizing medical management techniques the Social Worker supports the ACO in… more
- Humana (Boston, MA)
- …community and help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' ... care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied... of Pedatric member's (Under 21) who utilize Applied Behavioral Analysis (ABA Services). Monitor/have awareness of utilization… more
- Beth Israel Lahey Health (Woburn, MA)
- …with all Lahey Health policies and clinical protocols. * Complies with behavioral expectations of the department and Lahey Health . * Demonstrates an ... The Medical Assistant works in collaboration with the physician(s), other health care provider(s), and other ambulatory support staff within the department… more
- Highmark Health (Boston, MA)
- …in addition to 3 weekdays** 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
- Harvard University (Cambridge, MA)
- …members of the Harvard community. Our work includes multi-specialty ambulatory medical care, behavioral and mental health services, and campus public health . ... 66674BRAuto req ID:66674BRJob Code:403049 Health Assistant II Department Office Location:USA - MA...AGE SPECIFIC COMPETENCIES: Provides care to the adolescent through utilization of the following: a. Supplements explanations with reasons… more
- Beth Israel Lahey Health (Burlington, MA)
- …including Interqual, Rightfax, NaviHealth, Change Healthcare, Epic, etc. . Manages all utilization management work queues by researching and following up on ... appropriate coverage and escalates issues to the manager. . Assists Utilization Managers with all aspects of utilization review/discharge planning/performance… 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 Part-time Description As a Registered Nurse (RN) at Fenway Health you will provide compassionate, evidence-based, and efficient care to individuals,… more
- Beth Israel Lahey Health (Lawrence, MA)
- …a difference in people's lives.** Clinical Supervisor (LICSW / LMHC) - Community Behavioral Health Center located in Lawrence, MA. **Job Description:** + **Sign ... of the Urgent Care/Mobile Crisis Program, including the appropriate utilization and management of staff and quality...Medicaid and non-Medicaid services. Ensures smooth access to MassHealth behavioral health services in the area by… more
- Beth Israel Lahey Health (Charlestown, MA)
- …the accounts payable payment reporting and control function. Activities include: utilization of ERP system to: review daily payment/banking information loads, ... to our financial systems, approves vendor master file adds/updates for organization. Utilization of the IRS FIRE and International Tax Navigation Systems for… more
- Highmark Health (Boston, MA)
- …, physician practice management or clinical operations, ancillary provider management or clinical operations, and/or health insurance) with significant ... knowledge of and experience with various care delivery models + Experience in health plan provider network performance management , care/case management ,… more
- Beth Israel Lahey Health (Lynn, MA)
- …with the multi-disciplinary treatment team to enhance the smooth delivery of quality behavioral health care. Requirements: Masters in Social Work or Mental ... Health Counseling required. License eligible in related field (SW,...job responsibilities: Assumes responsibility for the clinical oversight and management of assigned patients, demonstrating a robust commitment to… more
- Beth Israel Lahey Health (Burlington, MA)
- …Activities:** 1. Participate in the development and support of formulary management and medication utilization initiatives that promote the cost-effective ... health care professionals about the drug therapy prescribing, management and monitoring 5. Provide support for the LCPN...* Comply with all Lahey Policies. * Comply with behavioral expectations of the LCPN Division. * Maintain courteous… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …schedules, for all clinical staff. EDUCATION: + Bachelor's or master's degree in behavioral health , health care administration or related field preferred. ... the productivity of professional staff by assisting with the utilization of existing reports and the creation of new...health care a plus + Experience with data management and analytics. + Prior healthcare operations and quality… more
- Harvard University (Cambridge, MA)
- …experience in a medical setting. Familiar with managed care and case management principles. Physical Requirements: All Harvard University Health Services (HUHS) ... members of the Harvard community. Our work includes multi-specialty ambulatory medical care, behavioral and mental health services, and campus public health .… more
- Highmark Health (Boston, MA)
- …(NCQA), Utilization Review Accreditation Committee (URAC), Pennsylvania Department of Health , Department of Labor, the Center for Medicare and Medicaid Services ... review and make determinations regarding physician reviewer assignments for medical management decisions. Cases requiring physician review are provider and member… more