Clinical Care Reviewer II - Massachusetts - R11559

+h2>Job Summary · Clinical Care Reviewer II – Behavioral Health is responsible for processing medical necessity reviews for appropriateness of authorization for behavioral health care services... · Complete prospective concurrent and retrospective review of Behavioral Health serv ...

Job Summary: · Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as we ...

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million memb ...

GROW WITH US: · Tandem Diabetes Care creates new possibilities for people living with diabetes, their loved ones, and their healthcare providers through a positively different experience. We'd love for you to team up with us to "innovate every day," put "people first," and take t ...

Registered Nurse/Licensed Practical Nurse - Per Diem · Compensation: LPN $40/hour & RN is $43/hour + shift differentials up to $6/hour more · About Us: · Want to know what makes our employees eager about going to work every day? The people we serve. Being a part of Maplewood ...

· We are seeking a highly skilled Cardiologist Consultant specializing in Imaging Review to provide expert analysis and interpretation of cardiac imaging studies. This role involves collaborating with multidisciplinary teams to ensure accurate diagnosis and optimal patient care. ...

Clinical Care Reviewer II – Behavioral Health is responsible for processing medical necessity reviews for appropriateness of authorization for behavioral health care services and assisting with discharge planning activities. · ...

Site: Mass General Brigham Medical Group, 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 care, research, ...

Case Manager - Registered Nurse · Cambridge, MA/Local candidates not accepted*** · 6 months · Shift: 40 hours per week · Usually M-F 8-4:30 · Occasional weekend may be required · Epic experience preferred · COVID Vaccines + Booster required at time of submission (declinations not ...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safe ...

Concert Health is seeking an experienced and mission-driven Medical Director to serve as the psychiatrist lead and liaison to a valued health system partner. · This unique role combines direct clinical consultation within the Collaborative Care Model (CoCM) with clinical innovati ...

Law Clerk IEmployment Type: Full Time, Mid-LevelDepartment: Legal · CGS is seeking a Law Clerk to join our team supporting the legal mission of a large federal agency. This position will allow candidates to demonstrate expertise in providing litigation support tasks like cite che ...

Job Title: LPN/RN Wellness Nurse · Location:  Mill Hill Residence · Employment Type: Full Time 3p-11p · Salary Range: $42 · Department: Healthcare/Resident Care · About Us: · Want to know what makes our employees eager about going to work every day? The people we serve. ...

We're looking for a Loan Processing Assistant to support the preparation, documentation, · and verification of loan applications.Collect review and organize applicant documents (IDs bank statements forms etc) · Verify loan application details for accuracy and completeness · Maint ...

:About Us: · Navvis is a leading population health company, driving performance in value-based care. As an operating partner to some of the country's most innovative health systems, physician enterprises, and health plans, we provide solutions that accelerate the journey to value ...

Law Clerk IIEmployment Type: Full-Time, ExperiencedDepartment: Legal Services CGS is seeking an experienced Law Clerk to provide assistance in all phases of litigation for a large federal agency office. This is a high-profile office involved in many high priority cases where your ...

We are seeking a talented individual for a Nurse Reviewer (RN) to support our Massachusetts contract. This role involves performing clinical reviews to determine if the medical record documentation supports the need for the service based on clinical criteria, coverage policies, a ...

Job Summary: · The Outreach & Marketing Specialist is responsible for promoting Commonwealth Care Alliance's (CCA) and CCA-CA - health products to individuals, responsible parties, and groups at a variety of settings. This position is also responsible for executing our marketing ...

The Physician Editor (Obstetrics-Gynecology) position requires an 80 to 90% FTE commitment for editorial work and a broad understanding of clinical issues. · ...

Review EMS run reports for accuracy and completeness in documentation and patient care.Candidate needs to be able to read and comprehend PCR report data quickly. · ...