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Lahey Health Utilization Analyst Case Mgmt - Full time - Day shift in Burlington, Massachusetts

Welcome To

Welcome to Lahey Hospital & Medical Center, part of Beth Israel Lahey Health. Lahey Hospital & Medical Center is a world-renowned tertiary medical center known for its innovative technology, pioneering medical treatment and leading-edge research. A teaching hospital of Tufts University School of Medicine, the hospital provides quality health care in virtually every specialty and subspecialty, from primary care to cancer diagnosis and treatment to kidney and liver transplantation. It is a national leader in a number of health care areas, including stroke, weight management and lung screenings, among many others. Lahey also helps to advance medicine through research and the education of tomorrow's health care leaders.

About the Job

Position Summary:

The Utilization Analyst works with physicians, the payers and inpatient case management team to validate the medical necessity of the hospital care.

Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case managers analyze medical documentation to ensure that proper reimbursement will be achieved in coordination to the intensity of medical care provided.

Minimum Qualifications:

Education:

RN, Bachelor’s degree desirable.

Licensure, Certification & Registration:

RN; RN with CDIP, CCM, ACM highly desirable.

Experience:

Must have at least 5 years inpatient UR/CM experience

Knowledge of payment methodologies, federal and state regulations, organization and communication skills required.

Shift

DAYS

About Us

Beth Israel Lahey Health is an integrated system providing patients with better care wherever they are. Care informed by world-class research and education. We are doctors and nurses, technicians and social workers, innovators and educators, and so many others. All with a shared vision for what healthcare can and should be. We are committed to attracting, developing and retaining top talent. We strive to create a diverse and inclusive workplace that reflects the communities in which we work and serve. With a team approach to care, we encourage learning and growth at all levels and offer competitive salaries and benefits.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.

REQNUMBER: 164504-1A

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