, concurrent, retrospective utilization management reviews utilizing Interqual ®, company policies and procedures.... As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe...
POSITION SUMMARY: The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible... knowledge of utilization management, denials management, performance improvement, and managed care reimbursement. Analytical...
. -Maintains awareness of health insurance changes. -Maintains compliance with regulation changes affecting utilization management...+ years of Utilization Review experience 2+ years management experience Preferred Skills: Master’s Degree Nursing...
and other members of the health care team. 4. Utilizing industry accepted utilization and/or medical management criteria (InterQual... COORDINATOR (CASE MANAGER) BWH CARE CONTINUUM The RN Care Coordinator (RNCC) manages a caseload of patients and is responsible...
POSITION SUMMARY: The Complex Care Manager works with relevant stakeholders to identify and engage clients... in intensive clinical care management with a focus on successfully addressing client’s behavioral health and social determinants...
Overview: The Long-Term Care (LTC) Sales Account Manager is responsible for establishing access and generating demand... trends in utilization gaps, drop-offs, or prescriber feedback. Collaborate with Regional Account Management, Market Access...
of appropriate, quality care; monitors treatment and rehabilitation progress; provides oversight of case management services... summary and not all inclusive): Conduct utilization management reviews Conducts in person screenings and needs & means...
Job Description Summary The Conduct Risk Management Office at State Street is seeking a program manager to join the... utilization of an industry leading RegTech application for the management of various compliance risks including: insider trading...
for Primary Care Physicians. The position reports to the District Manager and will collaborate closely with Marketing, Market... appropriate utilization of approved primary care product(s); the incumbent will work closely with cross-functional partners...
for Primary Care Physicians. The position reports to the District Manager and will collaborate closely with Marketing, Market... appropriate utilization of approved primary care product(s); the incumbent will work closely with cross-functional partners...
Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex... will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities...
Certified Care Manager (CCM) 1+ years of community case management experience coordinating care for individuals with complex... will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities...
Care Supervisor will also provide backup to the Senior Practice Manager for approved time away, unplanned absences, weekly..., providers, staff and management Comfortable working with patient and show care and compassion. Be able to provide a consistent...
within the Behavioral Health Community Partners (BH CP) care management program with leadership responsibilities as a Senior Case... highest quality health care for all individuals and families experiencing homelessness in greater Boston. Over 10,000 homeless...
, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high... Essential Functions Assist with the creation, continual update and management of a standard operating procedures document...
, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high... Infection Control & High-Level Disinfection/Sterilization (HLDS) Manager is a key leader within these academic medical centers...
required; pediatrics preferred. Experience as a Case Manager (Discharge Planning and/or Utilization Management) preferred. Licensure...Department Patient Services-Patient Care Operations AutoReqId 83561BR Status Full-Time Standard Hours...
Pharmacy Manager, Ambulatory Clinics Job Profile Summary This role focuses on providing pharmacy related services... and making decisions regarding organization growth and diversification to accomplish entity's vision. A management role...
Lemuel Shattuck Hospital is seeking a dedicated and experienced Case Manager to coordinate key functions... within our Case Management Program. The ideal candidate will ensure appropriate use of healthcare resources by reviewing admissions...
reimbursement source. This care manager is dedicated to handle the increased volume and to support the overall care management... for Utilization Review. Position: Case Manager (on site) Department: Denials and Appeals Schedule: 30 Hours (Weekends) Weekend...