- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
- Fenway Health (Boston, MA)
- …MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+02215) * Nursing Job Type Part-time Description As a Registered Nurse ( RN ) at Fenway Health you ... environments. Requirements + Education: Associate degree in nursing + Current Massachusetts Registered Nurse ( RN ) license degree required. + Current… 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
- Covenant Health (Nashua, NH)
- …out any significant changes or new information to the team. Job Requirements + Registered Nurse licensed in New Hampshire required Job Knowledge and Skills + ... Summary RN Case Managers provide a systematic collaborative approach...of five years broad clinical experience preferred + Case management and/or Utilization Management experience… more
- Elevance Health (Boston, MA)
- …managing the clinical operations department. Manages the delivery of quality care management , clinical utilization and referral services. **Location:** Remote - ... psychiatric nursing experience and minimum of 5 years of behavioral healthcare experience and minimum of 3 years managed...unrestricted license in a mental health field as an RN , PhD, LCSW (as applicable by state law and… 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 ... from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations to serve some of… more
- Highmark Health (Boston, MA)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Beth Israel Lahey Health (Danvers, MA)
- …Registration: Site Managers who are also licensed nurses in the State of Massachusetts ( Registered Nurse or Licensed Practical Nurse ) must also maintain BLS ... for transfer, promotion, and special training to ensure most effective utilization of individual skills and staff development. Supervises work performance of… more
- Commonwealth Care Alliance (Boston, MA)
- …as well as the team's daily operations, including the member experience, care management , care coordination, and care delivery. The Clinical Manager will ensure that ... Care Partner Team is primarily responsible for providing longitudinal care coordination, care management , and care delivery to a dedicated panel of CCA members, a… more