Case Manager, Denials and Appeals, 40 Hours - Boston

Review of potential transfers to the BMC System for tertiary care utilizing medical necessity screening tools to complete initial and continued stay reviews in determining appropriate level of patient care appropriateness of tests/procedures and an estimation of the patient's exp ...

+Job summary · The care manager will assess, plan, implement, monitor and evaluate the options and services required to meet an individual's health needs. · +ResponsibilitiesAssess patient's health needs. · ...

The Nurse Manager oversees daily operations of Utilization Management (UM) and Clinical Appeal teams. · Collaborates with interdisciplinary teams to reduce payer denials.Provides leadership, staff training, and quality improvement initiatives. ...

The Nurse Manager for Utilization Review and Clinical Appeal Management oversees daily operations of UM and Appeal teams ensuring compliance with hospital policies regulatory requirements payer guidelines. This role supports efficient effective utilization review denial managemen ...

The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible for overseeing the daily operations of the Utilization Management (UM) and Clinical Appeal teams. · ...

The Nurse Manager oversees daily operations of Utilization Management UM and Clinical Appeal teams ensuring compliance with hospital policies regulatory requirements payer guidelines supporting efficient effective utilization review denial management processes collaborating inter ...

The Nurse Manager for Utilization Review and Clinical Appeal Management ensures compliance with hospital policies regulatory requirements payer guidelines while supporting efficient effective utilization review denial management processes. · Collaborates with interdisciplinary te ...

The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible for overseeing the daily operations of the Utilization Management (UM) and Clinical Appeal teams. This role ensures compliance with hospital policies, regulatory requirements, · Leadership & Op ...

The Nurse Manager for Utilization Review and Clinical Appeal Management oversees daily operations ensuring compliance with hospital policies regulatory requirements and payer guidelines while supporting efficient utilization review denial management processes. · Nursing degree: D ...

We are looking for an Event Floor Plan Designer to assist with drafting and space planning to create functional and visually appealing 2D floor plans for exhibits that optimize space and traffic flow. · ...

The Medical Director provides clinical leadership for utilization management medical policy and quality oversight to ensure compliant cost-effective and high-quality care for Health Plan members. · Make medical necessity determinations including initial reviews appeals and grieva ...

We are seeking an Event Floor Plan Designer to assist with drafting and space planning for exhibits that optimize space and traffic flow. · Collaborate with account managers, sales, and operations teams. · Design accurate floor plans, carpet layouts, mark-out plans, and other ope ...

We are looking for Python Developers to work with one of our clients to support one of the most reputable brands in Big Tech build bleeding edge products. · ...

+Job summary · Esta empresa busca un desarrollador Python para apoyar a una empresa líder en tecnología. · +Responsibilities · Su rol será apoyar el Software Engineering función incluyendo construir CI/CD pipelines & crear scripts basados en python desde cero. · ...

The Advancement Office Intern will play a crucial role in supporting the organization's development efforts.Learn and help maintain timelines and workflows for annual and special campaign appeals. · Support data entry, segmentation, and mailing list preparation within the donor d ...

This position in the Office of Student Financial Services reports to the Managing Associate Director of Student Financial Services. The Assistant Director assists students and parents with offering financing options and with navigating the financial aid application process. · ...

Robert Half's marketing & creative client is looking for an Event Floor Plan Designer for a 3-month contract in the Greater Boston area. This is a remote opportunity. · Draft and space planning to create functional and visually appealing 2D floor plans. · ...

Jackson HealthPros is seeking a travel Radiology Technologist for Boston. · ...

We are seeking an independent vendor to deliver top-quality landscaping services for residential properties. · ...

We're building our brand and are looking for employees to join the Bertucci's family and help us grow – brick by brick through innovation and excellence. · We want to know what inspires the fire inside of you.Primary responsibilities: Responsibilities may include but are not limi ...