- Lawrence General Hospital (Lawrence, MA)
- The Utilization Review Specialist , under supervision and in collaboration with the Utilization Review Coordinator, Utilization Review Nurses, ... well as the integrated care team and supports the case management/ utilization review team on system-wide quality improvement/performance improvement initiatives.… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …Time + Employee Discount Program + Employee Assistance Program Job Description: The Utilization Review Specialist is responsible for monitoring adherence to ... Westborough Behavioral Healthcare Hospital is looking for a UR Specialist to provide Per Diem coverage. Benefits Include +...the hospital's utilization review plan to ensure the effective… 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 ... Office of Housing and Livable Communities (EOHLC_*_)__i*s seeking a HomeBASE Specialist Floater in the Division of Housing Stabilization!*_ *_AGENCY MISSION:_* The… more
- Pfizer (Boston, MA)
- …patients. **What You Will Achieve** The Rare Cardiac, Amyloidosis Multi-disciplinary Specialist (AMS), will target health care providers (HCPs), spanning multiple ... will report into the Area Business Manager (ABM). Amyloidosis Multi-disciplinary Specialist (AMS) will demonstrate strong business acumen, and an expert… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …+ 1 year of clinical and/or related experience required. Case Management, Utilization Review and/or Prior Authorization experience is preferred. + ... Working in a fast-paced, high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals… more
- Beth Israel Lahey Health (Burlington, MA)
- …manager. . Assists Utilization Managers with all aspects of utilization review /discharge planning/performance improvement processes. . Functions as liaison ... line with payer expectations, contributing to favorable revenue cycle. The Operational Specialist position will have an impact on provider, patient, and staff… more
- Cambridge Health Alliance (Cambridge, MA)
- …team leader in multi-disciplinary team discussion regarding treatment planning, treatment review , quality assurance and utilization review ... Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry **Date Posted:** 09/24/2024 **Requisition...public healthcare system is seeking a per diem Clinical Specialist II (APRN) to join our team. CHA is… more
- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific clinical ... staff, nursing staff, and other healthcare professionals. The Clinical Pharmacy Specialist will participate in the development of clinical guidelines/protocols, new… more
- Beth Israel Lahey Health (Boston, MA)
- …Employees must reside in MA, NH, or RI. Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific clinical area, ... staff, nursing staff, and other healthcare professionals. The Clinical Pharmacy Specialist will participate in the development of clinical guidelines/protocols, new… more
- Beth Israel Lahey Health (Charlestown, MA)
- …to the accounts payable payment reporting and control function. Activities include: utilization of ERP system to: review daily payment/banking information loads, ... correct or release data into the ERP system upon verification, review payment forecasts, offset credit balances against applicable debits, review payment… more
- Tufts Medicine (Lowell, MA)
- …resolve accounts, including Patient Access, Revenue Integrity, Coding, Medical Records, Utilization Review , Hospital Departments, Physician's Offices, and other ... the delivery of support services or activities, typically under supervision. A specialist level role that requires very advanced knowledge of operational procedures… more
- Lawrence General Hospital (Lawrence, MA)
- … Works collaboratively with the Complex Care Nurse Managers, Social Workers, and Utilization Review Nurses, in coordinating and providing care that is safe, ... timely, effective, efficient, equitable and client-centered. Assuming all administrative responsibilities within the admission and discharge planning, Perform other duties as needed and assigned by your supervisor. JOB RESPONSIBILITIES: + Perform the full… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Recall Specialist is dedicated to supporting the new product review . process and supporting organizational wide value analysis committees. Additionally, this ... activities and initiatives. Provide support to all product conversions. Evaluate the utilization of the products we use post implementation, help to educate others… more
- Tufts Medicine (Boston, MA)
- …(BPS) credential in a related area of practice. 6. Experience in drug utilization review and analysis. **Minimum Qualifications of a Clinical Pharmacist** : ... either through residency training or prior job experience. 4. Experience in drug utilization review and analysis **Duties and Responsibilities** **:** The duties… more
- Highmark Health (Boston, MA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to assure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- Beth Israel Lahey Health (Burlington, MA)
- …required forms per procedure and department protocol Follows up with patient or specialist to ensure patient care plans since last appointment were followed and ... results are available for physician review Confirms that lab and other ancillary tests are...data for identified patient populations Monitors patient progress by utilization of disease specific registries to proactively reach out… more
- Verint Systems, Inc. (Boston, MA)
- …enrollment processes, including obtaining and analyzing benchmark data and utilization data, identifying trends, preparing recommendations with impact assessments ... across plans to address issues, discuss trends & best practice, utilization and opportunities for improvement. + Responsible for ensuring internal compliance… more
- ManpowerGroup (Boston, MA)
- …Analyst reporting to the Information and Network Security Manager to establish, review and maintain the full range of information technology policy and oversight ... licensees. This position must develop a staffing plan to review 3rd party security audits of clients licensees and...Provide consultative guidance and direction to leadership on the utilization and capabilities of the information security and data… more
- Boston University (Boston, MA)
- …This position plays a crucial role in enhancing the discoverability and utilization of Boston University's rich historical and cultural holdings for both the ... 5-7 years of relevant experience. Preferred Qualifications + Digital Archives Specialist Certificate + CRM and project management experience For consideration,… more
- Ensono (Boston, MA)
- …complexity assignments - owner (1 or >) Low complexity assignments - provide oversight/ review Regularly lead self and others and/or established as Product SME and/or ... established as specialist Understands how whole picture aligns to overall Ensono...and unscheduled Database refreshes Improve processes and procedures Log-file review Complex trouble-shooting and repairs Reporting on state of… more