Manager Utilization Review - Somerville

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 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 ...

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,++Expertise in clinical review for prospective concurrent retrospective utilization management reviews utilizing Interqual company policies and procedures and other resources ...

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. · ...

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

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. · ...

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 ...

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 manage ...

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. · ...

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

BCBSMA is seeking a new Dental Utilization Reviewer to join our elite Dental Utilization Management Division. · The team includes dentists, dental hygienists, and dental assistants. · ...

The Physical Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness and medical necessity of outpatient rehabilitation and other services within scope of practice per business needs. · The role requires collaboration with a team of professionals ...

Ready to help us transform healthcare? Bring your true colors to blue. 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 opt ...

Ready to help us transform healthcare? Bring your true colors to blue. · BCBSMA is seeking a new Dental Utilization Reviewer to join our elite Dental Utilization Management Division · The team includes dentists, dental hygienists, and dental assistants. · ...