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Utilization Manager Jobs in Boston

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Search Results - Utilization Manager Jobs in Boston
Harbor Health Services, Inc.-Boston
participants. We are currently seeking a talented Utilization Management Nurse to join our care teams at the Elder Service Plan. Harbor Health offers a comprehensive Benefits package including Health, Dental and Vision Insurance, generous Paid Time Off (PTO)...
Lifelancer-Boston
Job Title: Associate Medical Director, Utilization Management Job Location: United States Job Location Type: Remote Job Contract Type: Full-time Job Seniority Level: Mid-Senior level Company Overview Cohere Health is a fast-growing clinical...
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Beth Israel Deaconess Medical Center-Boston
and Responsibilities: 1, Performs a variety of concurrent and retrospective utilization management-related reviews and functions to ensure that appropriate data are tracked, evaluated, and reported.  •  Collaborates with the health care team to determine the appropriate...
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 Medical Center (BMC)-Boston
of previous 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...
Leading Age-Boston
maintain necessary credentials to retain the position  •  5+ years of clinical practice beyond residency/fellowship  •  Utilization Management experience Preferred:  •  Fellowship program in Spine Surgery  •  1+ years of managed care utilization review experience...
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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...
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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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...
Boston Medical Center (BMC)-Boston
planning, utilization management, case management, performance improvement, and managed care reimbursement.  •  Understanding of pre-acute and post-acute venues of care and post-acute community resources.  •  Strong organizational and time management skills...
Well Sense-Boston
for our members, no matter their circumstances. Job Summary: The Medical Director will report to the Senior Medical Director of Utilization Management, Member Appeals & Grievances, and Medical Policy (Senior Medical Director of Utilization Management...
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Element Care-Boston
strategies to reduce costs and improve quality of care/service. Works with health care providers outside of the center to coordinate interdisciplinary approach to providing continuity of care, including utilization management. Ensures staff provides...
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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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Leading Age-Boston
/solutions/services, expert consulting (partner-level), or related payer-facing roles.  •  2 years of Utilization Management experience within a health plan or vendor.  •  MBA or advanced degree in healthcare-related discipline preferred.  •  Membership in national...
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