- 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 ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… 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. * ... OBOT RN Case Manager **Date Posted:** 01/16/2025 **Requisition...admission utilizing specific criteria to identify needs related to utilization management and/or discharge planning. Refers appropriate cases to… more
- Brockton Hospital (Brockton, MA)
- …accepted criteria and guidelines to conduct review of inpatient admissions. The Case Manager at Brockton Hospital serves as the primary liaison between ... of five years clinical experience in an acute care facility required. Prior experience in case management, utilization review or discharge planning required. more
- Erickson Living (Hingham, MA)
- …of medical practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that ... risk stratification, high-risk members will be identified, and a case opened for members who meet the criteria for...goals, and outcomes. + The Care Coordinator will measure case performance based on program goals, objectives, quality indicators,… more
- Milford Regional Medical Center (Milford, MA)
- …with other members of the healthcare team, the Point of Entry/Emergency Department Case Manager (POE/ED CM) is accountable for coordination and facilitation of ... with knowledge of current medical care technology and ancillary supports. Previous utilization review experience preferred Must be assertive with excellent… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. The Clinical Care Manager is responsible for facilitating care for members and families of members who ... Mobile, and Resident personas. The Team The Clinical Care Manager is part of a highly dedicated and motivated...to promote optimal member outcomes. + Interpret and apply case management criteria, processes, policies, and regulatory standards to… more
- Beth Israel Lahey Health (Beverly, MA)
- …care givers, and families. Their functions include concurrent and retrospective review to assure appropriate utilization , assessment, prevention of denials ... team, you're not just taking a job, you're making a difference in people's lives.** **Job Description:** Case managers serve as the care coordinators for patients,… 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 ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- Sevita (Marlborough, MA)
- …receipt from accounting staff; identify any discrepancies to accounting staff + Coordinate utilization with the Case Manager relative to program ... trained to provide individual assistance to each person we serve. **Program Services Case Coordinator- Bilingual in Mandarin preferred.** Do you enjoy working in a… 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 ... disability. The Care Manager , RN upholds the current standards of professional case management practice, and reports to the Manager of Care Management. **Job… more
- Pfizer (Andover, MA)
- …Production Optimization that aim to improve product quality, increase asset utilization /uptime, automate manual workflows, and streamline plant floor operations. The ... control levels, all the way to the top of the Enterprise. The Manager , Manufacturing Operations Solutions - PLM colleague will spearhead development of solutions… 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. ... client expectations and working with leading global businesses? Your RoleAs a Manager in Employer Health, you will provide strategic and technical employee benefit… 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 ... recurrence are effectively implemented while also ensuring an effective injury case management process is fully implemented, well understood, and functioning as… 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 ... appointment were followed and results are available for physician review Confirms that lab and other ancillary tests are...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. Reviews, manages… 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 ... including Interqual, Rightfax, NaviHealth, Change Healthcare, Epic, etc. . Manages all utilization management work queues by researching and following up on all… more
- Sevita (Canton, MA)
- …meetings, including clinical team meetings and regularly scheduled supervision meetings + Coordinate utilization with the Case Manager relative to program ... Join us today, and experience a career well lived. **Program Services Case Coordinator - IDD Services** **Full Time Hybrid Role (home/office/site visits)** **Office… more
- CDM Smith (Boston, MA)
- …global corporate teams with accounting- and tax-related matters. * Monitor and review deliverables from local finance teams to ensure timeliness, accuracy, and ... and control activities, with an emphasis on streamlining them by utilization of Oracle Enterprise Management Software solutions, such as Financial Consolidation… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …+ **Minimum Experience:** + 1 year of clinical and/or related experience required. Case Management, Utilization Review and/or Prior Authorization experience ... overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + Monitors email communication to the Drug… more
- Beth Israel Lahey Health (Woburn, 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 ... appointment were followed and results are available for physician review o Confirms that lab and other ancillary tests...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. o Reviews,… 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 unit ... appointment were followed and results are available for physician review . - Confirms that lab and other ancillary tests...Serves as a liaison with patients, families to physicians, case managers, 3rd party payers, et al. - Reviews,… more