- 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
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Position is eligible for our FLEX persona. The position serves as a Prepayment Review Coding Specialist within the Fraud Investigation & Prevention Unit ("FIP"). ... review processes with other departments to prevent inappropriate utilization of resources 11. Form recommendations regarding process improvements to eliminate… more
- Beth Israel Lahey Health (Wakefield, 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
- Pfizer (Boston, MA)
- …patients. **What You Will Achieve** The Rare Cardiac, Amyloidosis Multi-disciplinary Specialist (AMS), will target health care providers (HCPs), spanning multiple ... will report into the Area Business Manager (ABM). Amyloidosis Multi-disciplinary Specialist (AMS) will demonstrate strong business acumen, and an expert… 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
- State of Massachusetts (Boston, MA)
- …Livable Communities (EOHLC) is seeking an Emergency Assistance (EA) Housing Search Specialist in the Division of Housing Stabilization!_* *_ _* *_AGENCY MISSION:_* ... to Massachusetts communities. *_OVERVIEW OF ROLE:_* The EA Housing Search Specialist assists family shelter providers (private non-profit agencies) across the… 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
- Beth Israel Lahey Health (Burlington, MA)
- …in people's lives.** **Job Description:** **Position Summary:** The Clinical Pharmacy Specialist - Population Health works collaboratively with other health care ... patients, and guideline development and implementation. Additionally, the Clinical Pharmacy Specialist supports the safe, effective and efficient use of medication… 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
- Lawrence General Hospital (Lawrence, MA)
- …Office product suite. Preferred: * Bachelor's degree * Case Management, Utilization Review or Prior Authorization experience * Bilingual English/Spanish ... Manager and Director of Integrated Care, the Infusion Clinical Authorization Specialist is responsible for ensuring all information for proper financial… 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
- 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
- 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 (Peabody, 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
- Verint Systems, Inc. (Boston, MA)
- …enrollment processes, including obtaining and analyzing benchmark data and utilization data, identifying trends, preparing recommendations with impact assessments ... across plans to address issues, discuss trends & best practice, utilization and opportunities for improvement. + Responsible for ensuring internal compliance… more
- Beth Israel Lahey Health (Cambridge, MA)
- …service line development/enhancement and analysis of hospital based clinical programs. Review and development with assistance in Implementation of new models and ... across Mount Auburn its financial performance and its relation to patient utilization of the integrated delivery system's emergency, inpatient and other services.… more
- Owens & Minor (Boston, MA)
- …off smaller account locations to virtual sales team as needed. + Ensures full utilization of internal specialist teams in support of assigned accounts. + ... Participates in Business Development reviews with Sales leadership to review strategy and progress. **Maintains full responsibility and accountability...Coordinates specialist activities for all customers across the region/territory (Distribution,… more
- Boston University (Boston, MA)
- …This position plays a crucial role in enhancing the discoverability and utilization of Boston University's rich historical and cultural holdings for both the ... including Computational Archival Science. Preferred Qualifications + Digital Archives Specialist Certificate + CRM and project management experience For… more
- Ensono (Boston, MA)
- …complexity assignments - owner (1 or >) Low complexity assignments - provide oversight/ review Regularly lead self and others and/or established as Product SME and/or ... established as specialist Understands how whole picture aligns to overall Ensono...and unscheduled Database refreshes Improve processes and procedures Log-file review Complex trouble-shooting and repairs Reporting on state of… more
- Beth Israel Lahey Health (Peabody, 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 o Confirms that lab and other ancillary tests...for identified patient populations o Monitors patient progress by utilization of disease specific registries to proactively reach out… more