- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …years of clinical experience in Behavioral Health Care settings + Utilization Management experience preferred + CCM or other applicable certification(s) ... your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care...management system, MedHOK What You Bring : + Behavioral Health professional with an active independent Massachusetts license:… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …us transform healthcare? Bring your true colors to blue. The RoleThe Clinical Utilization Reviewer is responsible for facilitating care for our Medicare ... our Hingham, MA office. Hours of work: 8:30a - 4:30p EST. The TeamThe Clinical Utilization Reviewer is part of a highly dedicated and motivated team of… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …health care settings (Inpatient, outpatient, or differing levels of care). + Utilization Management experience, preferred + Active licensure in Massachusetts is ... and regulatory standards to create, follow and appropriately document comprehensive care management plans. + Review medication list and educate members with… more
- The Home for Little Wanderers (Plymouth, MA)
- …documentation and assessments in a timely manner. Ensure that documentation meets utilization review and quality assurance standards. + Attend in-service ... grades 3 to 6 who have educational, emotional, and behavioral challenges that cannot be adequately addressed in a...program and in the family's home. + Provide case management services; act as a liaison with collateral agencies;… more
- Sevita (Canton, MA)
- …as requested + Organize and chair program participant conferences + Review the designated program participant's reports (evaluation, progress, and discharge) for ... clinical team meetings and regularly scheduled supervision meetings + Coordinate utilization with the Case Manager relative to program participant's incentive… more