- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets… more
- Parexel (Boston, MA)
- …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
- Commonwealth Care Alliance (Boston, MA)
- …partnerships programs, working with clinical community partners responsible for care management and utilization management across CCA's One Care and ... programs. - Manages information, education and training to CCA staff , clinicians employed by CCA's clinical groups,...& Language (nice to have): - Familiarity with care management and utilization management systems… more
- Commonwealth Care Alliance (Boston, MA)
- …and provider relationship management tools. - Understanding of claims operations, utilization management , and quality programs as they relate to provider ... including provider communications, trainings, and forums. - Demonstrated leadership and team management experience, with the ability to develop staff and lead… more
- Monte Nido (Boston, MA)
- …and distractions (eg not in car) when meeting with clients or joining a clinical staff meeting. You will need a reliable video conferencing setup including ... and outpatient providers + Interact with insurance companies for pre-certification and utilization management + Participating in discharge and aftercare planning… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- Beth Israel Lahey Health (Burlington, MA)
- … documentation improvement results in a clear and concise manner to the medical, clinical , and management staff . 12. Applies diplomacy and professionalism ... necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue...when interacting with physicians and clinical staff ; especially when addressing missing or… more
- Beth Israel Lahey Health (Westwood, MA)
- …systems to enter and access patient care information. 7. Participates in quality management and utilization review programs. 8. May coordinate the work of ... you're making a difference in people's lives.** Job Summary: The Pharmacy Direct Staff Pharmacist is responsible for the quality assurance of the provided pharmacy… more
- Tufts Medicine (Lowell, MA)
- …to weekend clinical and administrative staff . + Provides the direct management of the Weekend clinical staff , schedulers, intake supervisor and ... Weekend Clinical coordinators. Provides supervision to clinical staff rotating to the weekend assignments....regarding pre and post weekend follow-up. + Promotes efficient utilization of resources to achieve desired clinical … more
- Cardinal Health (Tewksbury, MA)
- …ET goals + Utilizes DCOA as an objective tool to work with specific Medical Staff Departments or Utilization Management Teams to improve medication ... Health System Director of Pharmacy (HSD), Director of Pharmacy Operations and Account Management , and Cardinal Health Clinical Director, the Health System … more
- Evolent (Boston, MA)
- …a Clinical Reviewer, Nurse, you will routinely interact with leadership and management staff , other CR's ( Clinical Reviewers), providers, office staff ... Nurse, you will be a key member of the utilization management team. We can offer you...standards in the participating provider network and for other clinical staff . + Converses with medical office… more
- Tufts Medicine (Lowell, MA)
- … such as interviewing, hiring, and disciplinary action. + Promotes efficient utilization of resources to achieve desired clinical outcomes and within ... professional staff regarding: justification for appropriate home health service utilization in terms of frequency, duration, and type of service; rationale for… more
- Edwards Lifesciences (Boston, MA)
- …post-case management , 3 Mensio management , Therapy Awareness program management and clinical education programs. + Implementing sales and educational ... and implementing growth strategies within focused accounts in partnership with Sales Management . + Developing clinical champions among current and potential… more
- Beth Israel Lahey Health (Boston, MA)
- …. + Provides clinical consultation, support, education and mentoring to clinical staff . Assists with the communication and interpretation of changes in ... day/night rotating position with weekend and holiday rotation. The Administrative Clinical Supervisor (ACS) is the on-site senior administrative/ clinical person… more
- Deloitte (Boston, MA)
- …plans for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education ... clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG… more
- Fresenius Medical Center (Peabody, MA)
- …courses and that licensures/certifications are current. + Provides support for all clinical staff members at regular intervals and encourages professional ... eligibility for treatment. + Reports changes in patient status regarding any clinical , insurance, or travel and transportation issues. STAFF : + Participates… more
- Beth Israel Lahey Health (Burlington, MA)
- …. -Works cooperatively with all levels of personnel in the department. -Consults with other clinical staff on case management issues. 6) Conduct thorough and ... Ethics and Standards (on file in the department). 2) Provides sound clinical interventions (individual, couple, family and group therapies) as indicated. -Conducts… more
- Tufts Medicine (Melrose, MA)
- …in departmental policies and procedures. 15. Provides continuing education for the clinical staff (eg, pharmacists, physicians, nurses), serves as preceptor for ... **Inpatient Clinical Pharmacist-Med/Surg** **Job Profile Summary** This role focuses...training or prior job experience. 3. Experience in drug utilization review and analysis. **Duties and Responsibilities:** The duties… more
- Tufts Medicine (Boston, MA)
- … quality outcomes, evidence-based practices, and professional development of nursing staff . The Clinical Nursing Director works collaboratively with other ... research. **Job Overview** Tufts Medical Center is seeking a Clinical Nursing Director reporting to our Executive Director of...of RN Experience with at least 5 years of management experience. 3. Current Basic Life Support (BLS) Certification.… more
- Boston University (Boston, MA)
- …personal interaction). + Must be able to effectively communicate with patients, providers, staff and management + Comfortable working with patient and show care ... **FLOATING CLINICAL CARE SUPERVISOR, School of Dental Medicine, ...Care Supervisor must be able to effectively mentor the staff , provide training and support a team-centered environment, as… more
