• RN Director , Utilization Management…

    Fallon Health (Worcester, MA)
    …of care opportunities related to Utilization Management. + Works with VP/ Medical Director to set agenda related to UM and represent the plan at clinical ... purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief ... necessities and criteria for coverage. + Oversight of UM by delegated organizations and ensure regulatory and accreditation… more
    Fallon Health (12/14/25)
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  • Business Transformation Program Specialist

    Baystate Health (Springfield, MA)
    …Owner Support: o New user care management platform system overview training. o Medical Director care management platform system training, process support. o ... Development of Inter-Rater Reliability (IRR) reporting with UM /BH managers, at least annually. o Annual Reporting: State,...that are specific to the role) Bachelor's degree in Medical Information Systems or related field and 3 years'… more
    Baystate Health (01/08/26)
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