- Tufts Medicine (Lowell, MA)
- …with agency policy, State and federal home health regulations. Responsible for the management of cost effective, efficient care to home health and hospice patients ... support to weekend clinical and administrative staff. + Provides the direct management of the Weekend clinical staff, schedulers, intake supervisor and Weekend… more
- Tufts Medicine (Lowell, MA)
- …with agency policy, State and federal home health regulations. Responsible for the management of cost effective, efficient care to home health patients ensuring the ... members at least annually. + Collaborates with HR in aspects of personnel management such as interviewing, hiring, and disciplinary action. + Promotes efficient … more
- State of Massachusetts (Lexington, MA)
- …within their assigned residence under the direction of the Residential Services Director . Detailed Statement of Duties and Responsibilities: * Ensure compliance with ... and their families. * Makes recommendations to the Residential Services Director for hiring, disciplinary action, training, supervising and evaluating staff for… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to coverage decisions and final determinations regarding coverage in the BCBSMA utilization management system (MHK), so that decisions and medical reasoning ... as appropriate. At the request of the Senior Medical Director of the Physician Review Unit (PRU), the reviewer...practice in order to process appeals + Experience in Utilization Management in a managed-care or risk… more
- Abbott (Boston, MA)
- …the development / coaching of clinical representatives, as well as administrative management tasks. **ROLES & RESPONSIBILITIES** + Partner with Regional Sales ... Director , Territory Managers, and Sales Representatives to drive revenue...strategies to increase service efficiency and optimize clinical headcount utilization . Leverage best practices via network of Clinical Leaders… more
- Beth Israel Lahey Health (Burlington, MA)
- …direction of the Senior Vice President, the Emergency Department Chair and the Director of Emergency Nursing, the Business Manager is responsible for all product ... continuously improve operations. Other areas of responsibility include data and report management as well as system coordination, human resource management , and… more
- OptiMindHealth (Cambridge, MA)
- …all aspects of referral relationships including access, communication and medical management are working positively for these medical providers and healthcare ... to long term referral relations and recommend solutions to OptiMindHealth's Director of Physician Relations, Chief Operating Officer, and Chief Executive Officer.… more
- Point32Health (Canton, MA)
- …(https://www.point32health.org/) . **Job Summary** Under the direction of the Pharmacy Utilization Management (UM) Supervisor, the Per Diem Clinical Pharmacist ... projects as assigned by the Pharmacy UM Supervisor or Director **Qualifications** **- what you need to perform the...with Medicare Part B & D, Medicaid, and Drug Utilization Management . Prior authorization experience, including reviewing… more
- Beth Israel Lahey Health (Boston, MA)
- …problems or issues affecting patient flow, patient satisfaction, safety, length of stay management , or outcomes to the department director and/or appropriate key ... quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions… more
- Highmark Health (Boston, MA)
- …terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more