- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- Lincoln Financial (Boston, MA)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Highmark Health (Boston, MA)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Fresenius Medical Center (Springfield, MA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and on-… more
- Brockton Hospital (Brockton, MA)
- …patient flow and reduce service delays through problem resolution and follow-up. Monitors on- site case managers and utilization review staff to ensure ... management experience Proven experience in coordinating discharge planning and utilization review experience required. Prior management experience required.… more
- CenterWell (Marlborough, MA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Baystate Health (Springfield, MA)
- …appropriate management as outlined in the evidence based practice guidelines Uses Utilization Analysis /Management principles, insures that patient's site of ... strongly preferred + Requires a working knowledge of community resources and Utilization /Quality Review standards. + Understanding of the hospitals patient… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …range planning and determining staffing needs. + Assists Home Care Manager/Residential Nurse manager to monitor utilization and processes for stocking Nursing ... in policy review and revision. Works with Home Care Director/Residential Nurse Manager to update policies, procedures and workflows as needed to ensure… more
- Erickson Living (Peabody, MA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... for all team members over 18 years of age + Free access to our on- site Team member Health and Well-Being Centers, plus Well-Being programs, tools and resources for… more
- Fresenius Medical Center (Waltham, MA)
- …accurate. Oversees and monitors payer contracting functions for all Access Site locations. Oversees and monitors intake process including patient registration and ... insurance verification for all Access Site locations. **PRINCIPAL DUTIES AND RESPONSIBILITIES** : + Reimbursement + Monitors the day to day functions of the Patient… more