• Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding UR… more
    Beth Israel Lahey Health (12/14/25)
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  • Utilization Management Coordinator, SBH

    South Middlesex Opportunity Council (Framingham, MA)
    …individuals, children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. ... fashion, for the RRS and outpatient clinic programs. + Review denials and partially paid claims and...As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or incidental contact… more
    South Middlesex Opportunity Council (12/10/25)
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  • Director of Pharmacy Benefit Manager

    State of Massachusetts (Boston, MA)
    …delivery of health care services through networks of providers, or that employ utilization review systems to evaluate the medical necessity and appropriateness ... applications for licensure. Review is of carriers' operations, including utilization review , quality assurance, contracts with pharmacies and prescription… more
    State of Massachusetts (12/04/25)
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  • Hospital Case Manager , Registered Nurse

    Baystate Health (Springfield, MA)
    …and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers ... $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager ** The **RN Hospital Case Manager ** is...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
    Baystate Health (12/10/25)
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  • RN, Hospital Case Manager Per Diem

    Baystate Health (Springfield, MA)
    …and Competencies:** + Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by third party payers ... - $55.87 - $69.33 + **Per Diem Hospital Case Manager ** The **RN Hospital Case Manager ** is...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
    Baystate Health (11/29/25)
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  • Registered Nurse - Care Manager

    Lawrence General Hospital (Methuen, MA)
    …acute care setting with discharge planning, continuing care, care management, and utilization review preferred. + Strong verbal and written communications skills ... of the range to support future salary growth. The RN Care Manager collaborates with physicians, nurses, and other clinical staff/directors to coordinate, facilitate… more
    Lawrence General Hospital (12/13/25)
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