Supervisor of Utilization Review - Medford

Site: Mass General Brigham Health Plan Holding Company, Inc.Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient ca ...

We believe that high-performing teams drive groundbreaking medical discoveries.The Opportunity Manages a department of utilization review professionals usually consisting of Registered Nurses, Social Workers and other paraprofessional roles. · ...

Site: Mass General Brigham Health Plan Holding Company, Inc.Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient ca ...

+Job summary · The UMCM will utilize clinical knowledge to analyze, assess, · and render approval decisions,+Review authorization requests for medical services, · including making initial eligibility and coverage determinations, · ...

Manages a department of utilization review professionals and develops policies and processes for the team. · ...

Manages a department of utilization review professionals usually consisting of Registered Nurses, Social Workers and other paraprofessional roles. Develops and oversees policies and processes for the team and collaborates with other departments to improve the organization's utili ...

+Job summary · The UMCM will utilize clinical knowledge to analyze, assess and render approval decisions,++Expertise in clinical review for prospective concurrent retrospective utilization management reviews utilizing Interqual company policies and procedures and other resources ...

We are seeking a highly motivated Utilization Review RN to join our team. · Review prospective inpatient services. · Analyze retrospective review requests. · ...

Utilization Review RN to join our team to perform prospective, concurrent and retrospective review of inpatient, · outpatient, ambulatory and ancillary services. Skill & CompetenciesExcellent written · and verbal communication skills. · ...

Job summary · The primary purpose of the Utilization Review Specialist is to create and manage the flow of revenue for each client through liaison with insurance companies. · QualificationsHigh School Graduate or equivalent. · Post high school training in the medical field, the i ...

Job Summary:Westborough Behavioral Healthcare Hospital is looking for a Utilization Review Specialist to provide Per Diem coverage. · ...

The Utilization Review Specialist reviews patient care from admission through discharge to ensure medical necessity, · appropriate level of care, quality of services, · and compliance with payer requirements.This role collaborates closely with the interdisciplinary treatment team ...

The Utilization Review Specialist reviews each patient's care at regular intervals from admission through discharge by evaluating the medical record and collaborating with members of the interdisciplinary team. · This role participates in interdisciplinary clinical team meetings ...

Utilization Review Specialist · Status: Full-Time, 40 hours per week · Schedule: Monday–Friday, approximately 8:00 AM–4:00 PM · Pay Range: $33–$41 per hour (based on experience) · The Utilization Review Specialist reviews each patient's care at regular intervals from admission th ...

· Who Are We: · Westborough Behavioral Healthcare Hospital (WBHH) provides psychiatric stabilization and dual diagnosis treatments for Children, Adolescents and Adult populations in both inpatient and outpatient settings. Our goal is to ensure patients and their loved ones feel ...

The Utilization Review Specialist reviews each patient's care at regular intervals from admission through discharge by evaluating the medical record and collaborating with members of the interdisciplinary team.The purpose of this review is to determine medical necessity, appropri ...

The Utilization Review Specialist reviews patient care from admission through discharge to ensure medical necessity. · ...

Job Description · Duration: 4-5 month contract (With possible extension) · *Note: Candidate must hold an unrestricted Massachusetts RN license. Compact licensure is not required. · Overview: · We are seeking an experienced Inpatient RN Utilization Reviewer to independently mana ...

Westborough Behavioral Healthcare Hospital provides psychiatric stabilization and dual diagnosis treatments for Children, Adolescents and Adult populations in both inpatient and outpatient settings. · ...

The RN Utilization Management Reviewer is responsible for facilitating care for members who may have complex healthcare needs, authorizing medically necessary services at the right level of care to promote optimal health.This position is self-directed and works independently and ...

The PT Utilization Management Reviewer is responsible for facilitating care for members who may have complex healthcare needs. · This position is self-directed and works independently to facilitate care using clinical skills · ...