- Highmark Health (Boston, MA)
- …Analytical Skills + Advanced Problem-Solving + Advanced Communication Skills + Project Management + Customer Service + Leadership **EDUCATION** **Required** ... This role supports the full application product lifecycle for ** clinical and utilization management software** , with...The Open Framework Group (TOGAF) + Six Sigma + Project Management Professional (PMP) **Language (Other than… more
- Humana (Boston, MA)
- …communication of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient or ... hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management… more
- Humana (Boston, MA)
- …hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …with 3 years of clinical experience + Bachelor's degree in clinical discipline required, 2 years of utilization management experience required; health ... to blue. The Role:The Compliance Program Consultant will focus on utilization management compliance and audit readiness activities such as evaluating and supporting… more
- CenterWell (Boston, MA)
- …Revenue Cycle Professional (CRCP) * Lean Six Sigma (Green Belt or higher) * Project Management Professional (PMP) * Nursing license (RN or LPN/LVN) preferred but ... revenue integrity and patient access. The Director partners closely with clinical leadership, operations, finance, compliance, and IT, and manages both onshore… more
- Fujifilm (Boston, MA)
- …development and provide valuable feedback on products and market (ie coordinate clinical labs and office/conference evaluations for new products with KOL and global ... marketing teams). + Play a central role to provide clinical , technical, and market knowledge in the product franchise(s): which includes, but is not limited to… more
- Humana (Boston, MA)
- …and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, ... reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services.… more
- CenterWell (Boston, MA)
- …**Preferred Qualifications** + Advanced Degree + Prior experience in Process or Project Management **Additional Information:** As part of our hiring process ... a matrixed organization. The Director works in close partnership with Operations, Clinical Leaders, Workforce Management , HR, Product, and Technology teams to… more
- Dana-Farber Cancer Institute (Boston, MA)
- …funds across operating, federal, industry, foundation, donor, institutional, and clinical trial sources. You will provide senior-level financial planning and ... management , lead operational process improvements, and cultivate strong business...strong business relationships with Cancer Genomics leadership (Directors and Associate Directors). We seek a proactive professional who can… more
- Dana-Farber Cancer Institute (Boston, MA)
- … Clinical Trials Office to complete the regulatory requirements of the clinical research project . The RC coordinates aspects of protocol submissions, prepares ... (RC) works under the direction of the Breast Oncology Principal Investigator(s), Regulatory Operations Manager, Clinical Research Manager and / or directly for the… more