- South Middlesex Opportunity Council (Framingham, MA)
- …individuals, children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. ... fashion, for the RRS and outpatient clinic programs. + Review denials and partially paid claims and resolve discrepancies....As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or… more
- OptiMindHealth (Boston, MA)
- Physician Liaison / Outreach Coordinator Position Requirement: Part-Time FLSA Status: Non-Exempt Location: Boston, MA Join a leading clinician-led behavioral health ... and efficiency. This position is an entry level Physician Liaison / Outreach Coordinator role. Preferred candidates will possess a B2B Sales background with a strong… more
- Beth Israel Lahey Health (Burlington, MA)
- …department and must provide a detailed monthly report on any overage. 3) Review /modify min/max inventory levels. 4) Audits inventory levels not associated with Pyxis ... no expired products. Makes adjustments if needed. 9) In conjunction with Pyxis Coordinator and Purchasing, removes expired product and works with the vendors to… more
- Boston University (Boston, MA)
- …opportunities including emergencies and backfill patients into student provider open slots, review phone call and utilization reports to aid in optimal ... **PATIENT COORDINATOR , GROUP PRACTICE,SDM Clinical Affairs** **Job Description** **PATIENT COORDINATOR , GROUP PRACTICE,SDM Clinical Affairs** **Category**… more
- Massachusetts Institute of Technology (Cambridge, MA)
- …patients, families, providers, and community agencies. PREFERRED: two years of case management, utilization review , and discharge planning experience. 11/18/2025 ... Registered Nurse, Care Coordinator + Job Number: 25320 + Functional Area:...Save Save Apply Now Posting Description REGISTERED NURSE, CARE COORDINATOR , MIT Health, will serve as a core member… more
- US Tech Solutions (Boston, MA)
- …be directly associated with incoming referrals and authorizations for the utilization component of medical management. **Key Responsibilities/Duties - what you will ... an event or transaction by lines of business for the UM teams to review and decision requests + Contacts provider offices for further details on clinical… more
- Brockton Hospital (Brockton, MA)
- …delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare ... management experience Proven experience in coordinating discharge planning and utilization review experience required. Prior management experience required.… more
- Beth Israel Lahey Health (Burlington, MA)
- …**Essential Duties & Responsibilities including but not limited to:** 1) Performs utilization review and discharge planning to inpatient admissions. 2) Applies ... of Ethics, the Case Manager performs duties relative to utilization and discharge planning. The Complex Case Manager acts...Interqual, AEP and or other review criteria approved by the Clinic to accurately determine… more
- CVS Health (Boston, MA)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- SHI (Boston, MA)
- …position will schedule resources, manage escalations, track hours and budget, review deliverables, and maintain clear communication with stakeholders on project ... closure which includes project acceptance,andfinal invoicing, andconduct a thorough review toidentifylessons learned and best practices for future projects +… more
- Boston College (Chestnut Hill, MA)
- …guidance to ensure optimal placement outcomes. Individual Support Plan (ISP): Regularly review client records and follow the guidelines outlined in each client's ... networks (residential staff, legal guardians, DDS Service Coordinators, etc.). Encourage Utilization of Resources: Promote and encourage clients to engage with… more