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Utilization Manager Jobs in Boston

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Search Results - Utilization Manager Jobs in Boston
Commonwealth Care Alliance Inc.-Boston
The Director of Utilization Management leads and manages all utilization management (UM) functions for physical health services and long-term services and supports to ensure achievement of business results while maintaining compliance with all...
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Bournewood Health Systems-Brookline (MA), 4 mi from Boston
collection of all pertinent clinical data to support HLOC  •  Initiates appeals as requested and completes data collection as requested for QI indicators  •  Covers Utilization Management Director’s time away as necessary  •  Completes daily discharge forms...
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University of Massachusetts Medical School-Boston
to MassHealth utilization management (UM) strategy/policy development and functions.  •  Support and participate in all OCA medical management functions performed on behalf of MassHealth, including but not limited to coverage, medical necessity guidelines...
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VitalCore Health Strategies-Framingham, 20 mi from Boston
Electronic Medical Records (EMR), Utilization Management and other process improvement committees/initiatives as directed or assigned  •  Supports Company Initiatives and the application of best practices in clinical settings. Assists in the completion...
Monogram Health, Inc.-Boston
care and chronic condition treatment are delivered. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management...
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NR Consulting LLC-Hampton (NH), 42 mi from Boston
JOB DETAILS: Job Name- Licensed Practical Nurse (Local & Travel Both) REPORTS TO: RN Nursing Supervisor/Unit Manager/Center Nurse Executive Specialty- LPN – Skilled Nursing And Rehabilitation Must Have Skills/Experience: Active BLS/CPR, Active...
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Wasson Enterprise-Boston
The Practicing Medical Director is responsible for medical oversight of the Medical Management Program Description of P3 Health Partners regarding medical necessity decisions, utilization review, inclusive of prior authorization, concurrent...
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VitalCore Health Strategies-Framingham, 20 mi from Boston
Electronic Medical Records (EMR), Utilization Management and other process improvement committees/initiatives as directed or assigned  •  Supports Company Initiatives and the application of best practices in clinical settings. Assists in the completion...
Telligen-Boston
Medical Director As the Massachusetts Medical Director, you will be responsible for providing guidance on the clinical aspects of the utilization management program of Telligen and is responsible for the clinical decision-making aspects of the care...
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P3 Health Partners Inc.-Boston
medical licenses  •  Minimum 5 years practice experience  •  Minimum 2 years as a lead physician  •  Experience in managing Medicare Advantage (MA) populations in global risk arrangements preferred  •  Knowledge of utilization management to include experience...
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