- Beth Israel Lahey Health (Boston, MA)
- …exams. Enters all data into electronic health record. . Complies with all Managed Care and Quality requirements (required vitals, e-prescribing, etc). . Reports ... Respect, and Equity as outlined in our organization's WE CARE values which can be reviewed here Our Values....all pertinent observations to Physician, Office Manager, Director , or other health team member. . Coordinates surgical… more
- Atrius Health (Watertown, MA)
- …(preferably in ambulatory care clinical pharmacy) or have equivalent ambulatory care or managed care clinical pharmacy experience; preferably with ... Health,*part of the Optum family of businesses. We're an innovative health care leader and multi-specialty group practice, delivering an effective, connected system… more
- State of Massachusetts (Worcester, MA)
- …the Medicaid Management Information System (MMIS) to help resolve Medicaid and Managed Care Organization barriers to youth accessing healthcare services. * ... to accessing healthcare needs and services of youth in care or custody. They will serve as a member...with the Regional Nurses. * Collaborate with the Medical Director , the HMST Supervisor, Area Offices, and other specialty… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …order to participate in panel appeals + Experience in Utilization Management in a managed - care environment (as a clinician or in committee work, large group ... these requests. At the request of the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer...Perform additional tasks as assigned by the Associate Medical Director of the Physician Psychologist Review Unit + Adhere… more
- Molina Healthcare (MA)
- …a minimum of 2 years of experience in health plan quality improvement, managed care , or equivalent experience + Demonstrated solid business writing experience ... during the year + Works with the Manager and/or Director to maintain up-to-date addendums to quality policies and...opportunities for improvement + Surfaces to the Manager and/or Director any gaps in processes that may require remediation… more
- Beth Israel Lahey Health (Boston, MA)
- …development and training for all staff. Implements relevant information systems such as managed care and patient appointments and ensures the accuracy of data. ... of service to patients in a hospital-based, community-based, or private-based ambulatory care practice. Provides oversight, management and training in all areas of… more
- CVS Health (Boston, MA)
- …and with relevant external constituents** + **At least 3 years of experience in managed care which may include PBM, Pharma, market access, account management, ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Cognizant (Boston, MA)
- …Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in health ... Draft and submit the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with Medicare,… more
- Humana (Boston, MA)
- …in a management field + Prior healthcare industry experience, preferably in the managed care or provider sector **Reporting Relationships** The role reports to ... a Director within the Strategy team, works collaboratively with leaders...serve to achieve their best health - delivering the care and service they need, when they need it.… more
- Amgen (Boston, MA)
- …Medical Value Access Liaisons (MVAL) group in Scientific Affairs, reporting to a Director . Geographic region for this position is within the US business and majority ... Neuro Oncology therapeutic area expertise + Deep knowledge of managed markets, US Reimbursement Landscape, Pharmacoeconomics, Population Health, and...us** As we work to develop treatments that take care of others, we also work to care… more