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Utilization Manager Jobs in Boston

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Search Results - Utilization Manager Jobs in Boston
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...
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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SSTAR-Fall River (MA), 43 mi from Boston
oversees and directs all medical teams in utilization management, population health and wellness, clinician engagement, safety and quality, and patient engagement. As the advocate of the medical teams, the CMO through clinical leadership and direct patient...
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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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...
National Medical Association-Boston
may be possible. Responsibilities  •  Development and updating of departmental clinical policies and procedures along with the Clinical Administrative Director and Associate Medical Director  •  Oversee Clinical Quality Management and Utilization...
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Marlborough (MA), 25 mi from Boston
qualifications:  •  A bachelor's degree (B.A. or B.S.) is required; advanced degree is preferred.  •  A minimum of 5 years of experience working in coverage determination and utilization management within a commercial payer organization.  •  Established network...
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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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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...
Mass General Brigham-Belmont (MA), 6 mi from Boston
access to services for patients and, where appropriate, family members. ADMINISTRATIVE FUNCTIONS   4.  C ollaborate with the Utilization Manager to manage the patient's care in a manner that is both clinically and fiscally sound; where appropriate...

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