Utilization Manager Jobs in Massachusetts
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Search Results - Utilization Manager Jobs in Massachusetts
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...
Mass General Brigham-Somerville (MA)
management ability is preferred.
• Comprehensive knowledge of care coordination, utilization management, and utilization of community resources.
• Current registration in nursing in the Commonwealth of Massachusetts.
• Current certification required...
1 similar job: Brighton
Walden-Waltham (MA)
individual, group, and family therapy for patients with ARFID and other eating disorders
• Serving as liaison with families and outpatient providers
• Interact with insurance companies for pre-certification and utilization management
• Participating...
SSTAR-Fall River (MA)
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...
Mass General Brigham-Belmont (MA)
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...
VitalCore Health Strategies-Gardner (MA)
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...
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
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...
1 similar job: Toledo
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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Marlborough (MA)
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...
tiptopjob.com -
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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Monte Nido & Affiliates, LLC-Lowell
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...
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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Skinderm-Shrewsbury (MA)
Perform utilization review and utilization management to ensure appropriate use of healthcare resources
• Must have the ability to work autonomously
• Assist in all areas of practice operation as requested
Qualifications
• Medical degree from...
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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...
1 similar job: Worcester
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