of experience. Manages a department of utilization review professionals usually consisting of Registered Nurses, Social Workers...+ years of Utilization Review experience 2+ years management experience Preferred Skills: Master’s Degree Nursing...
POSITION SUMMARY: The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible... with hospital policies, regulatory requirements, and payer guidelines while supporting efficient and effective utilization review...
Nursing preferred Massachusetts Registered Nurse License required At least 2-3 years of utilization review experience..., and render approval decisions, to determine the need for physician review as well as complete determinations following physician...
COORDINATOR (CASE MANAGER) BWH CARE CONTINUUM The RN Care Coordinator (RNCC) manages a caseload of patients and is responsible... to discharge are met. 6. Incorporates knowledge of utilization management principles and payer contracts into patient plans...
Reporting to the Director of Engagement & Development, the Benefits Operations & Compliance Manager is responsible.... Develop and review standard reports and information for benefit programs for internal purposes and external reporting...
. 4. Experience in drug utilization review and analysis. 5. Experience with Electronic Medical Records. Duties...Pharmacy Manager, Ambulatory Clinics Job Profile Summary This role focuses on providing pharmacy related services...
Utilization Review, Performance Improvement, Risk Assessment, Infection Surveillance, and the coordination of discharge planning... and not all inclusive): Oversee case coordination, utilization review, discharge planning, and resource allocation across assigned units...
Description : Salary Range: $130,000-$150,000 Manager of Crew Deployment The Manager of Crew Deployment leads the... budget to meet financial targets. Analyze utilization of department workforce and facilities to continuously identify...
job description and in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization Review. POSITION...The UM RN will be responsible for review of potential transfers to the BMC System for tertiary care, in conjunction...
for Utilization Review. Position: Case Manager (on site) Department: Denials and Appeals Schedule: 30 Hours (Weekends) Weekend... in the attached job description and in the Utilization Review Plan in accordance with the CMS Conditions of Participation...
Job Description The Manager of Chargeback Operations is a critical role, reporting to the Associate Director... with DTE to manage enhancement backlog, trouble shoot issues. Research, review, and interpret complex data to evaluate...
Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient... Case Manager performance is evaluated using the Inpatient Case Manager Guidelines and audit tool. Reports to Inpatient Case...
.us and www.socomec.com About This Role The Customer Success Manager role is based in Watertown, MA and will be responsible... would be useful but not essential Utilization of Socomec Group Business Systems (ERP LN, Salesforce) - training provided Microsoft Office knowledge...
for demonstrating ROI to the partner account, ensuring both regular interaction and utilization review. Secure contracts... where infectious disease is no longer a major threat to human health. The Clinical Sales Manager is responsible for the sales efforts...
& development Position Overview The Fitness Manager oversees all aspects of the Personal Training (PT) department, ensuring... and maintain professional standards. Conduct monthly 1-on-1 meetings with each trainer to review performance, goals, client...
, and software/tool utilization (Procore/Templates/Guides). Field Checks: Review of project documents and specifications to aid... to: Regional Quality Manager Supervisory Duties: No The Quality Manager (QM) will collaborate with several project teams...
Job Description Job Description: Vertex Pharmaceuticals Inc. is seeking a Senior Manager reporting to the Director... with US and Global teams. The Senior Manager will play a meaningful role in supporting the day to day operations of the Managed Markets...
Utilization:** Leverage insights from Senior Vice President, General Manager, Team Leaders, and Senior Business Managers...**DESCRIPTION** As a **Business Manager,** you will play a pivotal role in driving our company's success by achieving...
Job Description: #LI-DE1 #LI-Onsite Responsibilities: The Business Operations Manager is responsible for the... and advise management on office space capacity and utilization, support office initiatives, maintain internal trackers...
Overview: The Long-Term Care (LTC) Sales Account Manager is responsible for establishing access and generating demand..., consultant pharmacists, and pharmacy directors to educate on clinical profile, access process, and appropriate utilization...