- Evolent (Providence, RI)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Intake Utilization Management ** at Evolent will serve as a ... regulatory requirements, and client contractual agreements. **Collaboration Opportunities** : The Coordinator , Intake Utilization Management reports directly… more
- State of Massachusetts (Milford, MA)
- *Program Coordinator I Duties - Office of Strategic Planning and Research - Research and Planning Division:* The Program Coordinator I - Data Analyst position ... will be part of the Research and Planning Division, reporting to a Program Coordinator II/III and the Deputy Director within the Office of Strategic Planning and… more
- Elevance Health (Smithfield, RI)
- **Pharmacy Services Coordinator ** _Location: This position will work a hybrid model (1-2 days/week). The ideal candidate will live within 50 miles of one of our ... Elevance Health PulsePoint locations._ The **Pharmacy Services Coordinator ** is responsible for being the primary contact and liaison for and between the company's… more
- Sunrun (Providence, RI)
- …+ Own and develop partner or branch relationships including weekly/monthly reviews, utilization and workload management , process updates and identification and ... commitment to diversity, inclusion and belonging. **Overview** The Field Service Coordinator is responsible for coordinating effective execution of field service… more
- Highmark Health (Providence, RI)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review, status… more
- Merck (Providence, RI)
- …expense reports, time‐off requests and provide proper oversight of CTC's productivity/ utilization . + Provide input for capacity planning, including reporting of ... issues to CRM and CRD/TA-Head. + People and Resource Management : - Manages CTC - career development, performance reviews,...the line manager. + Ability to proactively develop risk management and mitigation plans in the country and resolve… more
- Brockton Hospital (Brockton, MA)
- … program that enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management methods and techniques. ... post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge. Acts as...and develops reports that clearly monitor all areas of utilization /case management . Provides data, guidance and input… more
- State of Massachusetts (Brockton, MA)
- …(HSC Is) to ensure compliance with DMH Regulations, policies, and procedures. * Conduct utilization management reviews as well as audit and approve monthly case ... Multi Service Center (BMSC) is seeking an experienced Adult Case Management Supervisor (Human Service Coordinator II) to join the team. The Adult Case … more
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …not limited to: Receives and manages a community specialty care assignment. Provides utilization management and utilization review services. Provides care ... Preferred Experience: Outpatient care management /clinical care coordination Utilization review Utilization management Grade Determinations:… more
- Milford Regional Medical Center (Milford, MA)
- …dignity, compassion and respect. Statement of Purpose: The Substance Use Data Coordinator (SUDC) is accountable for performing audits, data entry, research, and ... analysis of healthcare data regarding federal, state and commercial quality and utilization information. The SUDC is also responsible for supporting and facilitating… more