- Commonwealth Care Alliance (Boston, MA)
- …& Utilization Mgmt **Position Summary** Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation ... facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible for providing accurate, prompt, and appropriate entry of… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA-Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances team in a ... and meeting all strict deadlines. + When necessary collaborate with care teams, clinical staff, family members, and other involved in providing care for our members.… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Certification as an Occupational Health Nurse (COHN) or Occupational Health Nurse Specialist (COHN-S) + Certification in Case Management + Certification in ... with travel by car or public transportation to other office/ clinical sites. + May travel to member's homes or...**Required Licensing:** + Unencumbered license to practice as a Registered Nurse in Massachusetts **Required Experience:** +… more
- Commonwealth Care Alliance (Boston, MA)
- …the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and authorization ... reports to the Director of Utilization Management * Oversees clinical decision review for services requiring prior authorization in...reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison… more
- Cambridge Health Alliance (Cambridge, MA)
- …Massachusetts licensure authorizing practice in an expanded role as a Psychiatric Nurse Clinical Specialist and authorization including prescriptive ... Practitioner - PACE **Requisition Number:** CHAP-2288 **CHA Psychiatric Mental Health Nurse Practitioner - PACE ( Clinical Specialist II)** **Cambridge… more
- State of Massachusetts (Taunton, MA)
- …policy, and that staff seeks consultation from the MAP Director and the program's RN MAP Consultant as needed. *_Please Note_**:* The position is 40 hours per week ... working with other agencies, such as DTA, Social Security, Mass Rehab, day programs, psychiatric and medical services to...team members, ie nursing, LPHA, Voc Rehab and Peer specialist . * Participates with LPHA, all staff and Persons… more