• 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 (10/02/25)
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  • RN, Manager , Utilization

    Humana (Boston, MA)
    **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
    Humana (09/28/25)
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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 (07/29/25)
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  • Utilization Manager Registered Nurse…

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
    Commonwealth Care Alliance (10/02/25)
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  • Care Transitions Jobs

    Beth Israel Lahey Health (Plymouth, MA)
    …its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management ** and ** Utilization Review** ... CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management ** This role is ideal for a … more
    Beth Israel Lahey Health (10/02/25)
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  • Utilization Management Medical…

    Elevance Health (Woburn, MA)
    ** Utilization Management Medical Director- NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (09/26/25)
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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 (08/16/25)
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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 (08/15/25)
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  • Manager , Integrated Care management

    Point32Health (MA)
    …Care. The Clinical Manager will also work closely with the SCO management team to monitor Utilization metrics specifically related to Acute/SNF admission and ... Under the administrative direction of the Director of Care Management / Senior Manager , the SCO Clinical ...Manager will also work closely with the SCO management team to monitor Utilization metrics specifically… more
    Point32Health (10/01/25)
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  • Warehouse Supervisor (2nd Shift)

    Performance Food Group (Whitinsville, MA)
    …Coordinates pick planning in conjunction with the Warehouse Manager . + Utilization of Company's warehouse management system and other technologies available ... candidate should possess:** + Strong knowledge of warehouse procedures, inventory management , and material handling equipment. + Experience with inventory … more
    Performance Food Group (09/13/25)
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