- 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 ... more
- Baylor Scott & White Health (Boston, MA)
- …Note: Benefits may vary based on position type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff. You oversee ... more
- Cambridge Health Alliance (Cambridge, MA)
- …and provides them with a business card. * Integrates the discharge planning/coordination and utilization review functions in the case management role. * ... more
- Sunrun (Boston, MA)
- …in through our commitment to diversity, inclusion and belonging. **Overview** The O&M Case Manager is responsible for coordinating effective execution of field ... more
- United Therapeutics (Boston, MA)
- …to meet the needs of the intended audience and contributors + End-to-end case processing, including data entry, QC, medical review , and regulatory submissions ... more
- Sevita (Lawrence, MA)
- …receipt from accounting staff; identify any discrepancies to accounting staff + Coordinate utilization with the Case Manager relative to program ... more
- Wolters Kluwer (Waltham, MA)
- …to set utilization goals and benchmark success, leveraging tools (reports, case studies, client references, etc.) to win and maintain customer support. . ... 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 ... more
- South Middlesex Opportunity Council (Worcester, MA)
- …for all assigned properties as detailed below. Working closely with an assigned Case Manager to ensure that all property, municipal, regulatory and contractual ... more
- Highmark Health (Boston, MA)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... more
- Deloitte (Boston, MA)
- …the C-Suite. Our services extend beyond HR to include the CEO, CFO, Risk Manager , and Business Unit leaders, delivering value and creating impact for our clients. ... more
- Nelnet (Boston, MA)
- …in territory by reviewing client contracts, maintaining contract end dates, championing utilization , and proactively engaging clients to extend/ review the term ... 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 ... 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 ... 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 ... 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 ... 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 ... more
- Elevance Health (Woburn, MA)
- …the medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts ... more
- Fallon Health (Worcester, MA)
- …and corrective action planning must be established for each respective case and adjudication completed in accordance with existing regulations, policies, and ... more
- Tufts Medicine (Boston, MA)
- …services as appropriate. Works in close collaboration with the Department's Business Manager in overseeing and supervising the entire team of Audiologists and ... more