- Beth Israel Lahey Health (Plymouth, MA)
- …and identifies trends/root causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee as appropriate. ... Certification required + Minimum of 3 years of progressive experience in utilization management and appeal/denial management . + Holds a strong working… more
- Brockton Hospital (Brockton, MA)
- …denials, appeals and reconsideration hearings. Works closely with the physician advisor to proactively intervene in cases where utilization of resources is ... program that enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management methods and techniques.… more
- Wolters Kluwer (Waltham, MA)
- …efforts, prioritizing efforts and resources for assigned customer portfolio. + **Ongoing Utilization Management ** + Oversee and analyze customer utilization ... Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider… more
- Beth Israel Lahey Health (Boston, MA)
- …discharge plan of care. Escalate deviations from the plan to the Physician Advisor as appropriate. Possesses effective verbal and written communication, ... quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions… more