- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
- Dartmouth Health (New London, NH)
- …care and resulting outcomes. * FUNCTIONAL DUTIES AND RESPONSIBILITIES * Clinical Case Management * Determines patient needs and resources within 1-2 business days ... and all members of the healthcare team. Participates with the physician/multidisciplinary to review the plan and progress of care, to evaluate the effectiveness of… more
- Sunrun (Concord, NH)
- …in through our commitment to diversity, inclusion and belonging. **Overview** The O&M Case Manager is responsible for coordinating effective execution of field ... and develop partner or branch relationships including weekly/monthly reviews, utilization and workload management, process updates and identification and resolution… more
- Beth Israel Lahey Health (Beverly, MA)
- …care givers, and families. Their functions include concurrent and retrospective review to assure appropriate utilization , assessment, prevention of denials ... team, you're not just taking a job, you're making a difference in people's lives.** **Job Description:** Case managers serve as the care coordinators for patients,… more
- Beth Israel Lahey Health (Exeter, NH)
- Case Manager Discharge Planning + Full Time + Exeter, NH 03833 ... through professional nursing care, rehab services, patient education and utilization of community resources in order to assure the...cases with social work team members to establish and review plans of care. 7. Works closely with Core… more
- United Therapeutics (Concord, NH)
- …to meet the needs of the intended audience and contributors + End-to-end case processing, including data entry, QC, medical review , and regulatory submissions ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… 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
- Beth Israel Lahey Health (Wakefield, MA)
- …engagement in healthy behavior. Working with the healthcare team, the Care Manager , RN monitors appropriate utilization of healthcare resources, promotes quality ... disability. The Care Manager , RN upholds the current standards of professional case management practice, and reports to the Manager of Care Management. **Job… more
- Highmark Health (Concord, NH)
- …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
- Highmark Health (Concord, NH)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case management, and… more
- Nelnet (Concord, NH)
- …in territory by reviewing client contracts, maintaining contract end dates, championing utilization , and proactively engaging clients to extend/ review the term ... for people where they live, learn and work. The Manager - Account Executives - Sales - NCC -...one time per year to deliver an annual account review communicating Nelnet's value and long-range planning objectives. 9.… more
- Lawrence General Hospital (Lawrence, MA)
- …acute care setting with discharge planning, continuing care, care management, and utilization review preferred. + Strong verbal and written communications skills ... The RN Care Manager collaborates with physicians, nurses, and other clinical staff/directors to coordinate, facilitate and expedite patient care services across the… 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
- Beth Israel Lahey Health (Beverly, 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 ... appointment were followed and results are available for physician review Confirms that lab and other ancillary tests are...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. Reviews, manages… more
- Beth Israel Lahey Health (Burlington, MA)
- …. . Assists Utilization Managers with all aspects of utilization review /discharge planning/performance improvement processes. . Functions as liaison for ... including Interqual, Rightfax, NaviHealth, Change Healthcare, Epic, etc. . Manages all utilization management work queues by researching and following up on all… more
- Elevance Health (Woburn, MA)
- …or regulation, must be in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- Elevance Health (Manchester, NH)
- …the medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts ... + Extensive orthopedic surgery experience preferred. + Experience with utilization management, especially with CMS guidelines preferred. For candidates working… 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 ... appointment were followed and results are available for physician review + Confirms that lab and other ancillary tests...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. + Reviews,… 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 ... 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