• Utilization Management…

    CVS Health (MA)
    …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
    CVS Health (01/16/26)
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  • Payment Integrity Clinician

    Highmark Health (Boston, MA)
    …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (11/14/25)
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  • Physician Reviewer ( Behavioral Health)

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …practice in order to participate in panel appeals + Experience in Utilization Management in a managed-care environment (as a clinician or in committee work, ... in process to evaluate clinical service requests + Practice anticipatory case management for members whose cases come for review, in partnership with case… more
    Blue Cross Blue Shield of Massachusetts (11/25/25)
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  • Physician Liaison / Outreach Coordinator

    OptiMindHealth (Cambridge, MA)
    …Part-Time FLSA Status: Non-Exempt Location: Cambridge, MA Join a leading clinician -led behavioral health company today! OptiMindHealth (OMH) is expanding ... compassionate professionals to join our team. Today, OMH provides superior behavioral health services to patients in Massachusetts, Colorado, and Montana. Since… more
    OptiMindHealth (11/06/25)
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  • LISCW - Geriatrics

    Beth Israel Lahey Health (Danvers, MA)
    …personnel in the department. -Consults with other clinical staff on case management issues. 6) Conduct thorough and accurate diagnostic assessments in compliance ... departmental case conferences --Present cases as requested. --Assist with new clinician orientation. --Participate in administrative functions as defined by the… more
    Beth Israel Lahey Health (01/13/26)
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  • Clinical Social Worker

    Beth Israel Lahey Health (Burlington, MA)
    …personnel in the department. -Consults with other clinical staff on case management issues. 6) Conduct thorough and accurate diagnostic assessments in compliance ... departmental case conferences --Present cases as requested. --Assist with new clinician orientation. --Participate in administrative functions as defined by the… more
    Beth Israel Lahey Health (12/24/25)
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  • Clinical Social Worker

    Beth Israel Lahey Health (Burlington, MA)
    …in the department. - Consults with other clinical staff on case management issues. 6) Conduct thorough and accurate diagnostic assessments in compliance with ... case conferences - Present cases as requested. - Assist with new clinician orientation. - Participate in administrative functions as defined by the department… more
    Beth Israel Lahey Health (12/21/25)
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