- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …providers, as appropriate. At the request of the Senior Medical Director of the Physician Review Unit (PRU), the reviewer also provides clinical leadership ... Ready to help us transform healthcare? Bring your true colors to blue. The physician reviewer is responsible for evaluating pre & post-service clinical service… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …healthcare? Bring your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for members who may have complex ... the following personas: eWorker, mobile and resident. The Team The Clinical Utilization Reviewer is part of a highly dedicated and motivated team of professionals,… more
- Brockton Hospital (Brockton, MA)
- TITLE: Physician Assistant, Transitional Services (Per Diem) REPORTS TO: Supervising Physician , Transitional Services DEPARTMENT: Transitional Care Services ... PURPOSE OF POSITION: The Physician Assistant employed in the Signature Healthcare Transitional Care...diagnostic judgments and appropriate treatment plans. . Participates in review of quality of patient care through peer record… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …appeals. This role works collaboratively with Provider Service, Claims, Network Management, Physician Review , and Medical and Payment Policy teams. Key ... your true colors to blue. The RoleThe Appeals Nurse Reviewer is responsible for reviewing provider claims appeals, validating...to nationally recognized billing processes. + Collaborate with the Physician Review Unit to assist with medical… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …medical records, schedule and conduct site visits to procure medical records from physician offices, work with physician offices to resolve issues related to ... He/she will assist the Program Manager in the training of all temporary HEDIS review staff and will provide direct supervision of temporary staff as needed by the… more
- Fresenius Medical Center (Plymouth, MA)
- …annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition ... adjustments and modifications to the treatment plan as indicated by the prescribing physician . Communicates problems or concerns to the Team Leader or physician .… more
- CenterWell (Sandwich, MA)
- …tests of function to patients in their homes or other settings to assist the physician in evaluating the patient's level of function. + Confer with the patient's ... physician and other health care team members and participate...coordination, range-of-motion and function or teach compensation measures. + Review /expand the retraining programs in a manner consistent with… more
- Athena Health Care Systems (Plymouth, MA)
- …nursing care, treatments, dressings, and other physician orders. + Transcribe physician 's orders promptly and accurately. + Review patient records daily to ... + Document and report any unusual or significant findings; contact the physician when necessary. + Administer medication according to procedure if applicable. +… more
- Athena Health Care Systems (Plymouth, MA)
- …nursing care, treatments, dressings, and other physician orders. + Transcribe physician 's orders promptly and accurately. + Review patient records daily to ... list. + Document and report any unusual or significant findings; contact the physician when necessary. + Administer medication according to procedure. + Maintain an… more
- Athena Health Care Systems (Plymouth, MA)
- …nursing care, treatments, dressings, and other physician orders. + Transcribe physician 's orders promptly and accurately. + Review patient records daily to ... list. + Document and report any unusual or significant findings; contact the physician when necessary. + Administer medication according to procedure. + Maintain an… more
- Erickson Living (Hingham, MA)
- …their family, and establishes and molds the relationship with the primary care physician and the patient + Through risk stratification, high-risk members will be ... the criteria for care coordination services. + Works with the primary care physician to establish protocols for routine and preventive care which reflect accepted… more
- Beth Israel Lahey Health (Plymouth, MA)
- …readmissions. **Functions and Responsibilities:** **A. Utilization Management** + Performs review of anticipated admissions utilizing InterQual criteria to assess ... reimbursement. + Refers inappropriate observation or anticipated admission cases to the Physician Advisor. + Provides real time interventions to prevent delays and… more
- Brockton Hospital (Brockton, MA)
- …Signature Healthcare Brockton Hospital; Signature Medical Group (SMG), a multi-specialty physician group of more than 150 physicians practicing in 18 ambulatory ... customer satisfaction. + Initiates the investigation of patient, family, physician or staff complaints and directs the complaint to...for educational offerings to be submitted to the appropriate review board as part of the application process for… more
- Brockton Hospital (Brockton, MA)
- …Signature Healthcare Brockton Hospital; Signature Medical Group (SMG), a multi-specialty physician group of more than 150 physicians practicing in 18 ambulatory ... in patient care under the supervision of a licensed physician as long as they are not performing a...patient's/family's questions or issues related to vaccine administration. + Review medical records for up-to-date problem list including patient… more
- Brockton Hospital (Brockton, MA)
- …Responsible for assuring continuity of care for patients under specific physician groups. Assesses plans, coordinates, and implements plans for quality, cost ... the delivery of services. Uses accepted criteria and guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as… more
- Brockton Hospital (Brockton, MA)
- …problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare Hospital standards, ... prompt notification of denials, questionable cases and cases referred for outside review . Monitors denial rate and develops remediation plans to address common… more
- CareWell Urgent Care (Norwell, MA)
- …with splinting/wound care and assisting in administering medications as directed by physician . Duties and Responsibilities: Medical Assistant - tasks include but are ... for clinical use, medical records use, billing use, physicians review , etc. + Document patient files, records, forms, and...and treatments. + Screen phone calls for referral to physician . + Maintain clinical and office supplies and equipment.… more
- Brockton Hospital (Brockton, MA)
- …Signature Healthcare Brockton Hospital; Signature Medical Group (SMG), a multi-specialty physician group of more than 150 physicians practicing in 18 ambulatory ... of Pharmacy, this position will assist in the ongoing review , maintenance, and enhancement of pharmacy operations and patient...as identified by pharmacist standard of care, etc. + Review medication therapies for appropriate dose for patients from… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Works with system management to create an efficient and timely financial operational review process. (essential) 3. Leads monthly operating review meetings with ... Responsible for obtaining and validating data supporting capital purchase needs, physician recruitment/replacement, and other investments. With the support of system… more
- Brockton Hospital (Abington, MA)
- …Signature Healthcare Brockton Hospital; Signature Medical Group (SMG), a multi-specialty physician group of more than 150 physicians practicing in 18 ambulatory ... practice guidelines and regulatory requirements + Managing and completing peer review activities to assure compliance with all organizational policies and protocols… more