Utilization Manager Jobs in Boston
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Search Results - Utilization Manager Jobs in Boston
Leading Age-Boston
to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.
The salary range for this position is $200,000 to $270,000 annually, based on years of utilization management experience; as part...
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Boston Children's Hospital-Boston
years nursing experience required, pediatrics preferred.
A certification as a Certified Case Manager is preferred, if not must obtain within the first two years of employment.
Experience as a Case Manager (Discharge Planning and or Utilization Management...
Boston Medical Center (BMC)-Boston
in a utilization management/case management position, required.
Knowledge And Skills
• Extensive background and knowledge of current medical/surgical patterns of practice.
• Medical terminology and standard medical abbreviations.
• Managed care concepts...
Northeast Health Services-Boston
They may supervise post-doctoral clinicians and trainees, participate in case reviews, and support utilization management. Proper documentation of all services is required.
Key Responsibilities:
Adhere to ethical and legal standards, including HIPAA...
Boston Medical Center (BMC)-Boston
and decision making, preferably in a utilization management/case management position, required.
Knowledge And Skills
• Extensive background and knowledge of current medical/surgical patterns of practice.
• Medical terminology and standard medical...
Boston Medical Center (BMC)-Boston
Licenses, Registrations Required
Licensed to practice as a Registered Nurse in the Commonwealth of Massachusetts
Experience
Minimum 5 years or more related experience in a Utilization Management, Denials and Appeals and patient insurance/billing preferred...
Boston Medical Center (BMC)-Boston
experience involving judgment and decision making, preferably in a utilization management/case management position
Knowledge And Skills
• Extensive background and knowledge of current medical/surgical patterns of practice.
• Medical terminology and standard...
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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McLean Hospital-Boston
with all hospital clinical and administrative policies
• Participates in utilization management, risk management, and quality assurance activities
• Participates in appropriate standing hospital committees
• Provides supervision of medical trainees, nursing...
Monte Nido & Affiliates, LLC-Boston
Interact with insurance companies for pre-certification and utilization management
• Participating in discharge and aftercare planning
• Therapeutic meal support, while modeling a healthy relationship with food
• Provides safe, empathetic, and affirming...
Casa Esperanza-Boston
job duties as assigned.
Administrative
Ensures adherence to program treatment philosophies and policies.
Maintains client and program records in accordance with agency requirements and timelines.
Assist with utilization management, which includes...
Boston Medical Center (BMC)-Boston
federal, and accreditation requirements related to case management and discharge planning.
Participate in audits, data collection, and reporting related to patient care outcomes and resource utilization.
Education
JOB REQUIREMENTS
Associate's Nursing...
Casa Esperanza-Boston
of aftercare planning.
Administrative: Ensures adherence to program treatment philosophies and policies.
Maintains client and program records in accordance with agency requirements and timelines
Assist with utilization management to include assessing...
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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Boston Medical Center (BMC)-Boston
involving judgment and decision making, preferably in a utilization management/case management position
Knowledge And Skills
• Extensive background and knowledge of current medical/surgical patterns of practice.
• Medical terminology and standard medical...
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