Utilization Management Care Manager - Somerville, MA

The Care Management Operational Compliance Manager reports to the Director of Clinical Operational Compliance and collaborates closely with the Legal, Regulatory Affairs, and Compliance (LRAC) department.The team member will provide clinical process expertise; identify impacts to ...

The UMCM will utilize clinical knowledge to analyze and render approval decisions. · Principal Duties and Responsibilities:Expertise in clinical review for prospective utilization management reviews utilizing Interqual. · Review authorization requests for medical services includi ...

The Clinical Care Manager (CCM) provides care coordination and clinical management for One Care enrollees with complex healthcare needs. · ...

A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. · ...

Reporting to the Director, · Care Management,the Manager,Care Management is responsible for directing care management operations and leading a team to deliver services that engage,motivate,and educate family caregivers to support complex individuals keeping care at home. · ...

The Manager, Care Management is responsible for directing care management operations and leading a team to deliver services that engage, motivate, · and educate family caregivers to support complex individuals, · keeping care at home.Lead and manage a team of clinical and non-cli ...

JOB DESCRIPTION Job SummaryProvides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contribute ...

Reporting to the Director, Care Management, the Manager, Care Management is responsible for directing care management operations and leading a team to deliver services that engage, motivate, and educate family caregivers to support complex individuals. · Lead and manage a team of ...

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. · At least 2 years health care experience, preferably in behavioral health, or equivalent combinati ...

About Us · A pioneer in the caregiving space, · Careforth supports family caregivers across the United States to confidently care for their loved ones at home.Position Summary · The Manager, Care Management directs care management operations and leads a team to deliver services t ...

Manager, Care Management directs care management operations and leads a team to deliver services that engage, motivate, and educate family caregivers to support complex individuals keeping care at home. · ...

This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. ...

As a Care Manager Nurse with eternalHealth you will be a core member at eternalHealth – whose responsibilities will include care management. · This position will work towards meeting clinical, financial and operational performance goals and standards. · We provide a unique oppor ...

We are seeking a Life Care Manager to join our team at Alder in Boston/Cambridge. The ideal candidate will have an advanced degree and licensure in social work, nursing, geriatrics, mental health or related field with 3-5 years experience working with older adults and families. · ...

We are looking for a Life Care Manager to join our team at Alder. · ...

We help families approach aging with confidence.Alder has been a trusted guide for over 30 years in Greater Boston. · ...

The Manager acts as a liaison between patients and families, department staff, physicians and the healthcare team, community agencies, managed care representatives, skilled nursing facilities, community agencies. The manager is responsible for establishing, implementing and monit ...

We are seeking a Managed Care Analyst I. The candidate will identify payment variances, collect underpayments from third-party payers and notify management when overpayments are detected.The Managed Care Analyst I will also identify payment trends, calculate impact and report fin ...

The Care Manager (BCM) is an essential member of the CBES Home Care Interdisciplinary Team. · ...

The Clinical Care Manager provides intensive care coordination and clinical care management for MassHealth Members with complex medical and behavioral health needs. · ...