- Covenant Health (Nashua, NH)
- …policies and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all ... health care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices.… more
- Spaulding Rehabilitation (Cambridge, MA)
- Case Manager - ( 3307312 )...**Experience** Preferred * 3-5 years of related experience. * Case management, utilization review , or ... nursing or outpatient setting is required. * Health plan experience in utilization review and case management will be considered. **Licensure** Required *… more
- Spaulding Rehabilitation (Charlestown, MA)
- Case Manager - ( 3308348 )...**Experience** Preferred * 3-5 years of related experience. * Case management, utilization review , or ... nursing or outpatient setting is required. * Health plan experience in utilization review and case management will be considered. **Licensure** Required *… more
- Adecco US, Inc. (Cambridge, MA)
- …include but is not limited to home care management, case management review , utilization review , social service support, insurance reimbursement and ... Adecco Healthcare & Life Sciences is hiring a contract hybrid Case Manager for our Pharmaceutical partner in Cambridge, MA. The anticipated hourly wage for this… more
- Beth Israel Lahey Health (Beverly, MA)
- …team, you're not just taking a job, you're making a difference in people's lives.** Case Manager RN **Job Description:** ** Case Manager RN** **Position ... care givers, and families. Their functions include concurrent and retrospective review to assure appropriate utilization , assessment, prevention of denials… more
- Sevita (Lawrence, MA)
- …receipt from accounting staff; identify any discrepancies to accounting staff + Coordinate utilization with the Case Manager relative to program ... to provide individual assistance to each person we serve. **Program Services Case Coordinator- Adult Day Health** Location: Oasis Adult Day Health Center Address:… more
- Wolters Kluwer (Waltham, MA)
- …set utilization goals and benchmark success, leveraging tools (reports, case studies, client references, etc.) to win and maintain customer support. ... quality and effective care. **ESSENTIAL DUTIES & RESPONSIBILITIES** The **Customer Success Manager - National Accounts** plays a lead role in managing and driving… more
- State of Massachusetts (Acton, MA)
- …policies and procedures, use of electronic health records, Medicaid billing system, utilization management, utilization review , risk management, and service ... skills including supervision, program planning/development, communication skills budgetary experience, utilization management and review , risk management and… more
- State of Massachusetts (Boston, MA)
- *Executive Office of Housing and Livable Communities (EOHLC*)*is seeking a** Manager of State Individual Homelessness Resource**s in the Division of Housing ... Massachusetts communities. *_OVERVIEW OF ROLE:_* This position functions as the manager for individual shelter operations team, which oversees unaccompanied adult… more
- Sysco (Boston, MA)
- **JOB SUMMARY** The District Sales Manager (DSM) role requires exceptional management of sale performance among Sales Consultants (SCs). This position is responsible ... developing the talent of their sales consultants to achieve profitable planned case and GP growth **RESPONSIBILITIES** + Manages the performance and development of… more
- Nestle (Sudbury, MA)
- …+ Risk Assessment and Elimination - Leads the effective implementation and utilization of risk assessment and risk prediction processes across sites to ensure ... recurrence are effectively implemented while also ensuring an effective injury case management process is fully implemented, well understood, and functioning as… more
- Triangle Inc. (Malden, MA)
- …+ Manages caseload of DDS, MRC, and private pay clients + Consults with Site Manager and staff to ensure consistent case management practices are followed + ... Position: Human Services Program Coordinator Reports to: Human Services Site Manager Hours: Full-time/Salaried , M-F, 8am-4:30pm Location: Broadway Tria ngle's… more
- Elevance Health (Woburn, MA)
- …appropriate area to refer or assign case ( utilization management, case management, QI, Med Review ). + Provides information regarding network providers or ... clinical information regarding case and determines...and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation… more
- Prime Therapeutics (Boston, MA)
- …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Magellan Credentialing criteria. + At minimum ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...Quality oversight for this program is provided by the Manager , Patient Programs. **Responsibilities** + Registered Nurse (RN). +… more
- State of Massachusetts (Boston, MA)
- …as needed to ensure compliance with program rules and regulations. . Conducts review of client files, incident reports, utilization and other program ... of HomeBASE and Rapid Rehousing, the Affordable Housing and Subsidy Resource Manager and collaborates closely with the Regional Teams and Housing Search Specialists… more
- Beth Israel Lahey Health (Burlington, MA)
- …Improvement and CQI issues as well as to unsafe working conditions. Notifies manager of concerns. Participates in unit-based QI activities and is familiar with unit ... appointment were followed and results are available for physician review o Confirms that lab and other ancillary tests...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. o Reviews,… more
- The Home for Little Wanderers (Boston, MA)
- …reports, documentation and billing in a timely manner. Ensure that documentation meets utilization review and quality assurance standards. + May be required to ... are referred for the program, overseen by a contract manager at DCF Central Office. The Per Diem YPC...and within family member's homes and community. + Provide case management services; act as a liaison with collateral… more