73 utilization management opportunities in Boston updated today
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· Page 1 / 4Our client is seeking a detail-oriented and clinically strong Inpatient Utilization Management Clinician who thrives in a fast-paced, collaborative environment. This individual will bring sound clinical judgment, strong communication skills, and the ability to navigate complex cases while ensuring r
Beth Israel Lahey HealthCharlestown, MA • Beth Israel Lahey Health • Full-time • Day When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Executive Director of Utilization Management (UM) provides strategic and operational leadership for the enterprise UM prog
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Utilization Management Coordinator - REMOTE. In this role, you will assist and support the clinical team with various administrative and non-clinical tasks that are essential to the processing of Util
Site: Mass General Brigham Incorporated 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, teaching, and community se
Site: Mass General Brigham Incorporated 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, teaching, and community se
Behavioral Health Utilization Management Medical Case Manager CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready
Ready to help us transform healthcare? Bring your true colors to blue. The Role 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. Th
Ready to help us transform healthcare? Bring your true colors to blue. The Role The Clinical Utilization 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 optimal health. Thi
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 care, research, teach
CenterWellBecome a part of our caring community Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team th
HumanaBecome a part of our caring community The Utilization Management Behavioral Health Professional uses behavioral health knowledge to support the coordination, documentation, and communication of medical services and benefit administration determinations. Reporting to the UMB Manager, the UMB Health P
VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the Regional Office in Hopkinton, MA!!! Start A New Career with VitalCore Health Strategies! At VitalCore we pride ourselves on retaining and acquiring hardw
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 care, research, teach
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 care, research, teach
Explore opportunities with Atrius Health, part of the Optum family of businesses. 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. Our entir
Join the VitalCore Team in Massachusetts! We're people who are fueled by passion, not by profit. VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare, has an opening for a Part-Time (16 hours per week) Utilization Management Scheduler at the Regional Office in Hopkinton
Senior Utilization Management Nurse – Field RN Location: Boston, MA Regional Area Schedule: Full-time | Weekdays only — no weekends, no holidays, no on-call About the Role At Optum, you’ll use your clinical expertise to ensure accurate medical record documentation, appropriate reimbursement, and hig
Join the VitalCore Team in Massachusetts! We're people who are fueled by passion, not by profit. VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare, has an opening for a Part-Time (16 hours per week) Utilization Management Scheduler at the Regional Office in Hopkinton
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 care, research, teach
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 care, research, teach
RxAdvanceCompany Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage of life. Success radiates across all levels of our organization, driven
Blue Cross Blue Shield of MassachusettsThe Role Ready to help us transform healthcare? Bring your true colors to blue. 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. Th
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The Role Ready to help us transform healthcare? Bring your true colors to blue. 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. Th
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 safety and quality in e
CVS HealthWe’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 safety and quality in e
Elevance HealthWound Care Utilization Management RN Carelon, a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center-connecting physical, behavioral,
A major health insurance provider seeks an RN Utilization Management Reviewer based in Hingham, MA. In this full-time role, you will facilitate care for members with complex health needs, conducting reviews to authorize necessary services using your clinical skills. The position offers flexibility f
*Our mission. Northeast Recovery is a network of Substance Use Disorder Treatment & Behavioral Health Treatment Facilities that provide a variety of levels of care to those who are prepared to begin their journey toward recovery and** *Salary: $50,000 – $95,000 per year (based on experience and
$67,000 – $105,000/year
Estimation confidence: Low
Estimate based on market data for Boston. Actual salaries may vary depending on experience, company, and area.
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