Manager - Utilization Review & Denials Management

Medical Care of Boston Management Corporation(20 days ago)

OnsiteFull TimeSenior$130,000 - $160,000Healthcare Management

About this role

This role is for a Utilization Review & Denials Management Manager in a healthcare setting, overseeing clinical denials, appeals, and utilization review processes to ensure efficient patient care and reimbursement. The position involves coordinating staff, managing data, and participating in improvement initiatives to support hospital operations.

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Required Skills

MS Office
Denials Management
Utilization Review
Appeals
Clinical Data Analysis
Payer Contracting
Level of Care
HIPAA Compliance
Reimbursement Strategies
Healthcare Policies

About Medical Care of Boston Management Corporation

cms.gov

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services (HHS) that administers the nation's major healthcare programs, including Medicare and Medicaid. CMS is responsible for overseeing the healthcare system in the United States, ensuring access to high-quality healthcare services and improving health outcomes for its beneficiaries. Through its initiatives and regulations, CMS aims to provide a more transparent healthcare system and reduce costs while enhancing care delivery across the nation.

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