• Manager , Utilization

    Commonwealth Care Alliance (Boston, MA)
    …services, procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of… more
    Commonwealth Care Alliance (05/21/25)
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  • Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
    Beth Israel Lahey Health (04/29/25)
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  • Manager Utilization

    Beth Israel Lahey Health (Burlington, MA)
    …taking a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for ... compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management . + Attends Mandatory Education programs required by… more
    Beth Israel Lahey Health (05/21/25)
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  • Coordinator, Utilization Management

    Evolent (Boston, MA)
    …contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
    Evolent (05/03/25)
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  • Manager Utillization Management

    Tufts Medicine (Burlington, MA)
    …with the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization ... to Utilization Review departments and UM vendor management . The UM Operations Manager is responsible...the Utilization Management Plan and assisting… more
    Tufts Medicine (05/22/25)
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  • Case Manager Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:**...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
    Beth Israel Lahey Health (05/11/25)
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  • Registered Nurse - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... + Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager more
    Beth Israel Lahey Health (05/17/25)
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  • Utilization Nurse

    Beth Israel Lahey Health (Plymouth, MA)
    …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... + Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager more
    Beth Israel Lahey Health (03/09/25)
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  • Resource Manager IT

    Baystate Health (Springfield, MA)
    …needs of each project. By forecasting future resource requirements and optimizing utilization , the Resource Manager helps Baystate Health meet its mission ... Monitor utilization and target hours against project plans Cost management : Contribute to project budgeting by ensuring efficient resource allocation and… more
    Baystate Health (04/11/25)
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  • ED RN Case Manager - UR & Discharge…

    Beth Israel Lahey Health (Plymouth, MA)
    …patient care status. This role is structured around four major functions + Utilization Management + Care Coordination + Discharge Planning + Preventing ... 3) Decreasing unit cost, 4) reducing readmissions. **Duties/Responsibilities:** **A. Utilization Management ** Performs review of anticipated admissions utilizing… more
    Beth Israel Lahey Health (05/21/25)
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