- Molina Healthcare (Worcester, MA)
- …performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... Collates and reports on Care Access and Monitoring statistics including plan utilization , staff productivity, cost effective utilization of services, management… more
- Evolent (Boston, MA)
- …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... performing precertification and prior approvals. Tasks are performed within the RN/ LVN /LPN scope of practice, under Medical Director direction, using independent… more