- Lawrence General Hospital (Lawrence, MA)
- The Utilization Review Specialist , under supervision and in collaboration with the Utilization Review Coordinator, Utilization Review Nurses, ... well as the integrated care team and supports the case management/ utilization review team on system-wide quality improvement/performance improvement initiatives.… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …Time + Employee Discount Program + Employee Assistance Program Job Description: The Utilization Review Specialist is responsible for monitoring adherence to ... Westborough Behavioral Healthcare Hospital is looking for a UR Specialist to provide Per Diem coverage. Benefits Include +...the hospital's utilization review plan to ensure the effective… more
- Beth Israel Lahey Health (Westwood, MA)
- …in people's lives.** * Hybrid / Remote schedule * The Clinical Pharmacy Specialist - Population Health works collaboratively with other health care providers and ... patients, and guideline development and implementation. Additionally, the Clinical Pharmacy Specialist supports the safe, effective and efficient use of medications… more
- State of Massachusetts (Boston, MA)
- …as needed to ensure compliance with program rules and regulations. . Conducts review of client files, incident reports, utilization and other program ... Office of Housing and Livable Communities (EOHLC_*_)__i*s seeking a HomeBASE Specialist Floater in the Division of Housing Stabilization!*_ *_AGENCY MISSION:_* The… more
- Veterans Affairs, Veterans Health Administration (Leeds, MA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Careers - Pharmacy: https://youtube.com/embed/Fn\_ickNBEws Facility Program Manager (Pharmacy Informatics/ADPAC Specialist ) GS-0660-13 GENERAL DESCRIPTION OF ASSIGNED DUTIES: The Program… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …+ 1 year of clinical and/or related experience required. Case Management, Utilization Review and/or Prior Authorization experience is preferred. + ... Working in a fast-paced, high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals… more
- Beth Israel Lahey Health (Burlington, MA)
- …manager. . Assists Utilization Managers with all aspects of utilization review /discharge planning/performance improvement processes. . Functions as liaison ... line with payer expectations, contributing to favorable revenue cycle. The Operational Specialist position will have an impact on provider, patient, and staff… more
- Cambridge Health Alliance (Cambridge, MA)
- …team leader in multi-disciplinary team discussion regarding treatment planning, treatment review , quality assurance and utilization review ... Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry **Date Posted:** 09/24/2024 **Requisition...public healthcare system is seeking a per diem Clinical Specialist II (APRN) to join our team. CHA is… more
- State of Massachusetts (Middleboro, MA)
- The Department is seeking to hire a Contract Specialist III (CS) to work in the DDS Southeast Regional Office in the Contracts Unit. The CS will ensure compliance ... and/or other Area office Staff involved in the contracting/engagement process to review the current status of engagement allocations, Purchase of Services (POS)… more
- Open Sky Community Services (Southbridge, MA)
- …supports, resulting in improved overall health, and reducing health care utilization . These programs are in partnership with referring Accountable Care Organizations ... and are funded by MassHealth. The Housing Specialist operates within the Housing First Principles to set...needed. + Provide follow-up home visits to support and review progress towards self-sufficiency including advocacy, reduction of isolation,… more
- Beth Israel Lahey Health (Boston, MA)
- …Employees must reside in MA, NH, or RI. Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific clinical area, ... staff, nursing staff, and other healthcare professionals. The Clinical Pharmacy Specialist will participate in the development of clinical guidelines/protocols, new… more
- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific clinical ... staff, nursing staff, and other healthcare professionals. The Clinical Pharmacy Specialist will participate in the development of clinical guidelines/protocols, new… more
- Beth Israel Lahey Health (Milton, MA)
- …level nursing experience (eg, ER, ICU) or equivalent case management, quality, or utilization review in a hospital setting Skills, Knowledge, and Abilities + ... Beth Israel Deaconess Hospital - Milton. The Clinical Documentation Specialist (CDS) provides a key role in facilitating long-term...of mortality, and severity of illness; and (b) track review details in 3M software. 2. Conducts follow-up reviews… more
- Beth Israel Lahey Health (Charlestown, MA)
- …to the accounts payable payment reporting and control function. Activities include: utilization of ERP system to: review daily payment/banking information loads, ... correct or release data into the ERP system upon verification, review payment forecasts, offset credit balances against applicable debits, review payment… more
- Tufts Medicine (Lowell, MA)
- …resolve accounts, including Patient Access, Revenue Integrity, Coding, Medical Records, Utilization Review , Hospital Departments, Physician's Offices, and other ... the delivery of support services or activities, typically under supervision. A specialist level role that requires very advanced knowledge of operational procedures… more
- Lawrence General Hospital (Lawrence, MA)
- … Works collaboratively with the Complex Care Nurse Managers, Social Workers, and Utilization Review Nurses, in coordinating and providing care that is safe, ... timely, effective, efficient, equitable and client-centered. Assuming all administrative responsibilities within the admission and discharge planning, Perform other duties as needed and assigned by your supervisor. JOB RESPONSIBILITIES: + Perform the full… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Recall Specialist is dedicated to supporting the new product review . process and supporting organizational wide value analysis committees. Additionally, this ... activities and initiatives. Provide support to all product conversions. Evaluate the utilization of the products we use post implementation, help to educate others… more
- Novo Nordisk (Springfield, MA)
- …sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy + Analyze ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications + Bachelor's or equivalent degree, and/or… more
- Highmark Health (Boston, MA)
- …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
- Beth Israel Lahey Health (Burlington, MA)
- …required forms per procedure and department protocol Follows up with patient or specialist to ensure patient care plans since last appointment were followed and ... results are available for physician review Confirms that lab and other ancillary tests are...data for identified patient populations Monitors patient progress by utilization of disease specific registries to proactively reach out… more