- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …adjudicate these requests. At the request of the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer also provides clinical ... Bring your true colors to blue. The Role The Physician Reviewer is responsible for evaluating clinical..., in partnership with case managers + Participate in Physician Psychologist Review Units' appeal process of… more
- Fallon Health (Worcester, MA)
- …on an interdisciplinary care team that may include the member's primary care physician , medical providers, behavioral health providers, state agencies and/or ... **Brief Summary of Purpose:** The Accountable Care Organization (ACO) Behavioral Health Case Manager (BHCM) is an...Health Pharmacist, referring members in need of medication review based upon Program process + Develops and fosters… more
- Veterans Affairs, Veterans Health Administration (Jamaica Plain, MA)
- …associate, scheduler and also has access to extended team members including behavioral health , clinical pharmacists, dieticians, social workers and peer ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Veterans Affairs, Veterans Health Administration (Jamaica Plain, MA)
- …associate, scheduler and also has access to extended team members including behavioral health , pharmacists, dieticians, social workers and peer partners. ... teams. Panel sizes are approximately 1250 patients per full-time physician and appointment lengths are 60 minutes for new...VABHS is leading the VHA's initiative in the Whole Health System of care which includes conventional treatment but… more
- Monte Nido (Dedham, MA)
- …passionate about delivering high-quality, patient-centered care in a collaborative behavioral health setting. **Pay:** $225,000.00-$275,000.00 depending on ... in the state of Massachusetts (or ability to obtain). + Experience in behavioral health , eating disorder treatment, or hospital-based medicine is preferred but… more
- CenterWell (Boston, MA)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... part of our caring community and help us put health first** We are excited to offer the role...a collaborating physician for nurse practitioners or physician assistants, including completing regular chart review … more
- OptiMindHealth (Needham, MA)
- …Part-Time FLSA Status: Non-Exempt Location: Needham, MA Join a leading clinician-led behavioral health company today! OptiMindHealth (OMH) is expanding and ... seeking compassionate professionals to join our team. Today, OMH provides superior behavioral health services to patients in Massachusetts, Colorado, and… more
- Highmark Health (Boston, MA)
- …as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent responds ... to physician and pharmacy network provider inquiries concerning oral, injectable...+ Prioritize requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. +… more
- Fallon Health (Milford, MA)
- …care including but not limited to working with providers to arrange medical and behavioral health appointments and following up with members afterwards to ensure ... + If working on the NaviCare Member Population: Facilitates transportation to medical, behavioral health , and social appointments by educating the member about… more
- Highmark Health (Boston, MA)
- …URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the multidisciplinary ... **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with… more
- Highmark Health (Boston, MA)
- …Registered Health Information Associate (RHIA) + Certified Coding Specialist Physician (CCS-P) + Certified Professional Coder (CPC) + Certified Outpatient Coder ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This...:** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret and… more
- Veterans Affairs, Veterans Health Administration (Jamaica Plain, MA)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... 401K with up to 5% in contributions by VA Insurance: Federal health /vision/dental/term life/long-term care (many federal insurance programs can be carried into… more
- Highmark Health (Boston, MA)
- …units that may assist in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the maintenance of the shared ... Informatics Intellectual Capital Repository to include but not limited to, review /editing of content submissions and best practices, audit reports, etc. The… more
- Highmark Health (Boston, MA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and ... days. **ESSENTIAL RESPONSIBILITIES** + Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD… more
- Highmark Health (Boston, MA)
- …**Job Description :** **JOB SUMMARY** This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as ... projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC...+ Assists with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work… more
- Fresenius Medical Center (Webster, MA)
- …Human Behavior and accepted methods of social work practice. Works with the health care team to promote positive adjustment, rehabilitation and improved quality of ... team, informs, educates and supports staff in understanding the emotional, psychological and behavioral impact of Chronic Kidney Disease on the patient and family to… more