- Novo Nordisk Inc. (Worcester, MA)
- …who need them most. At Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious chronic conditions such as obesity, ... positioning Novo Nordisk as a leader in the diabetes care market, understanding the local market and customer needs...Internally, the EDCS reports to the Endocrinology District Business Manager of the specific sales territory. The EDCS interacts… more
- Hartford HealthCare (Mansfield Center, CT)
- …and empowering individuals to participate in their own care and recovery. _*Job Summary*_ Utilization Review Care Manager coordinates the care of ... And this is* your moment.* **Job:** **Behavioral Health* **Organization:** **Natchaug Hospital* **Title:** * Utilization Review Care Manager - Behavioral… more
- Baylor Scott & White Health (Providence, RI)
- …Note: Benefits may vary based on position type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff. You oversee ... Success Factors** + Demonstrable knowledge in discharge planning, case management, utilization review and different care levels. + Outstanding written and… more
- Highmark Health (Providence, RI)
- …weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable… more
- Highmark Health (Providence, RI)
- …This job implements the effective utilization management strategies including: review of appropriateness of health care services, application of criteria ... consistent with established industry and corporate standards and are within the care manager 's professional discipline. Effectively function in accordance with… more
- Fallon Health (Worcester, MA)
- …follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Social Work Care Manager (SWCM) works very closely with Fallon Health Care ... Utilization Management Department assisting with difficult or complex care delivery or discharge planning needs for members o...meetings with providers and office staff and may lead care plan review with providers and … more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …team is expanding across sites to support this growth. We are currently hiring a Clinical Care Manager based in Milford, MA. The Clinical Care Manager ... , decreasing risk status, and minimizing hospital and ER utilization . + Identifies, manages, and coordinates patient care...patient care , ongoing evaluation, patient progress/risk status, care manager interventions, and a plan of… more
- Baystate Health (Springfield, MA)
- …MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate ... The Hospital Case Manager is a registered nurse responsible for the...+ Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
- Prime Healthcare (Woonsocket, RI)
- …unable to meet the patient's care needs. The ICM is responsible for the utilization review process as it relates to triage and admission to the Behavioral ... members to join its award-winning team! Landmark Medical Center is a 214-bed acute care hospital in Woonsocket, RI. The hospital has been "A"rated for patient safety… more
- South Middlesex Opportunity Council (Worcester, MA)
- …assigned properties as detailed below. Working closely with an assigned Case Manager to ensure that all property, municipal, regulatory and contractual requirements ... Illness, and Short-Term Disability. + Flexible Spending Accounts, Dependent Care Accounts, Employee Assistance Program, Tuition Reimbursement and more. Primary… more
- Prime Therapeutics (Providence, RI)
- …hoc reports are provided accurately and on time. + Supports the State Drug Utilization Review Boards and Pharmacy and Therapeutics (P&T) Committee. Potential pay ... every decision we make. **Job Posting Title** Pharmacist Account Manager - New York Remote **Job Description** + Leads...may vary by 8% depending on applicant location. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Milford Regional Medical Center (Milford, MA)
- …of current medical care technology and ancillary supports. Previous utilization review experience preferred Must be assertive with excellent interpersonal ... members of the healthcare team, the Point of Entry/Emergency Department Case Manager (POE/ED CM) is accountable for coordination and facilitation of the management… more
- Novo Nordisk (Springfield, MA)
- …Commercial team, you will have the opportunity to help people with obesity receive the care they deserve. The Novo Nordisk aspiration is to be a driving force in the ... providers, positioning Novo Nordisk as a leader in obesity care , understanding the local market and customer needs and...health. Internally, the OCS reports to the District Business Manager of the specific sales territory. The OCS also… more
- Fallon Health (Worcester, MA)
- …a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon ... Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top...and timely reports for internal and external customers on utilization trends, financial performance, quality management, and others. +… more
- Fallon Health (Worcester, MA)
- …and Post-Acute authorization request data and disseminates information to the Utilization Nurses for review . Additionally, supports the authorization process ... care or call center setting or physician's office; knowledge of managed care and/or utilization management strategies advisable + High level competency with… more
- Elevance Health (Smithfield, RI)
- …or regulation, must be in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to… more
- Hartford HealthCare (Wethersfield, CT)
- …(5) years of relevant clinical experience. Acute care or managed care utilization review is preferred. *_Licensure, Certification, Registration:_* ... gleaned during the review process is relayed to the Care Manager responsible for the patient. 10. Complete assignments to demonstrate expert knowledge… more
- Eastern Connecticut Health Network (Manchester, CT)
- …working with staff to create innovative ideas to improve employee engagement and patient care . What we offer: + Generous vacation that is front loaded based on ... organization POSITION SUMMARY: This position reports directly to the Administrative Manager and indirectly to the Director of Ambulatory Behavioral Health Services.… more
- Elevance Health (Smithfield, RI)
- …necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer ... for autism and depression, and insightful analytics to improve the delivery of care . The **Clinical Ops Associate Medical Director - Ortho** is responsible for… more
- Fallon Health (Worcester, MA)
- …care or call center setting or physician's office; knowledge of managed care and/or utilization management strategies advisable + Excellent writing skills ... a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon… more
