Sr Utilization Management Nurse – Telecommuter in Massachusetts - Boston

+Job summary · We are seeking a Preservice Review Nurse RN to perform pre-service/prior authorization clinical coverage review of Home Health services. · +Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit det ...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. · ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. · The work y ...

+ Job summary · As a LPN MDS-HC Coordinator you will be a valued member of an Integrated and complex clinical management model that is member-centric and facilitates collaboration between health care teams. · + QualificationsCurrent and unrestricted independent licensure as an LP ...

This position is for an Audit Team Lead who will oversee compliance reviews of medical and administrative documentation to identify healthcare fraud and wasteful conduct.We remove friction and drive alignment between care providers and payers, and ultimately consumers. · ...

This position is a leadership role in performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. · We remove friction and drive ali ...

The work you do with our team will directly improve health outcomes by connecting people with the care pharmacy benefits data and resources they need to feel their best.Audit entire medical record for accuracy of the coding on the MDS/ MMQ to support payment to the nursing facili ...

This position involves leading compliance reviews of medical and administrative documentation to identify instances of healthcare fraud. The role requires analyzing claims data, reviewing provider records, and presenting findings to clients. · Supervise auditors in performing com ...

We are improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting ...

+The State Ethics Commission seeks candidates for the full-time position of Assistant Enforcement Counsel.The State Ethics Commission is an independent state agency that civilly enforces the provisions of the conflict of interest and financial disclosure laws. · + ...

We are looking for a Senior Marketing Analytics Manager at our facility in Boston Massachusetts to develop and implement robust reporting to uncover actionable insights by identifying patterns trends and opportunities that drive business growth and improve customer experiences. · ...

We're an innovative health care leader and multi-specialty group practice delivering an effective connected system of care for adult and pediatric patients. As the Registered Nurse you will be responsible for effective care delivery and management of patient care within a special ...

Handle complex engineering tasks and project initiatives. Provide technical guidance and mentorship to junior engineers. · ...

A Patient Services Representative I will work under direct supervision to receive incoming calls and inquires assisting patients with appointment/care management while providing extraordinary customer service. · ...

Build and manage all stacks of an application including Front-end, Back-end, database, version control, server and APIs. Develop .NET applications using .NET Framework 4.5 and .NET CORE; Collaborate with Technology and Business teams; Lead a team of developers; Design user intera ...

Be part of our vision to transform care and improve lives by building trust, understanding and shared decision-making with every patient. Join us and discover the meaning behind Caring. Connecting. Growing together. · ...

We're an innovative health care leader and multi-specialty group practice, delivering an effective, connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts. · You'll be rewarded and recognized for your performance in an environm ...

As the Registered Nurse, you will be responsible for effective care delivery and management of patient care within a specialty, utilizing the nursing process and adhering to current standards of nursing practice. · ...

We're an innovative health care leader and multi-specialty group practice. Join us and discover the meaning behind Caring. Connecting. Growing together. · As the Patient Services Representative I you will work under direct supervision, receive incoming calls and inquires and assi ...

This position is remote in MA. You will have the flexibility to work remotely as you take on some tough challenges. · ...