• PCO Medical Director - UM - Full Time

    CenterWell (Boston, MA)
    …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
    CenterWell (11/06/25)
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  • Director of Research Nursing, Cancer…

    Beth Israel Lahey Health (Boston, MA)
    …Leadership Nurses Council and other leadership forums. 5. Collaborates with CCTO Director to develop and implement appropriate quality control guidelines to ... and advocating for the health of patients, families, and communities. The Nursing Director for the Cancer Clinical Trials Office (CCTO) reports directly to the CCTO… more
    Beth Israel Lahey Health (12/05/25)
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  • Medical Director - Medicaid N. Central

    Humana (Boston, MA)
    …scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions with external physicians by phone to ... and reviews for DME, genetic testing, etc. within their scope. The Medical Director may occasionally speak with contracted external physicians, physician groups,… more
    Humana (10/25/25)
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  • Medical Director - Medicaid (remote)

    Humana (Boston, MA)
    …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director more
    Humana (12/07/25)
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  • Director , Reporting & Analytics

    Cambridge Health Alliance (Cambridge, MA)
    …**Union Name** : Non Union Under the direction of the Associate Chief Quality and Patient Safety Officer, the Director of Reporting and Analysis provides ... Director , Reporting & Analytics **Requisition Number:** 10721 **Pay...on data requests for PI projects + Collaborate with Associate Chief Quality and Patient Safety Officer… more
    Cambridge Health Alliance (11/27/25)
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  • Medical Director - IP Claims Management

    Humana (Boston, MA)
    …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
    Humana (12/11/25)
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  • Medical Director -Payment Integrity

    Humana (Boston, MA)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
    Humana (12/11/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management Program for ... accrediting bodies. Works collaboratively with the multidisciplinary team to assure quality , timely and cost efficient care. Develops, implements and evaluates the… more
    Brockton Hospital (12/12/25)
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  • Medical Director - Nat'l IP UM Team

    Humana (Boston, MA)
    …of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex… more
    Humana (11/15/25)
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  • Clinical Director of Women's Health…

    Tufts Medicine (Boston, MA)
    **Clinical Director of Women's Health & Longevity Program** **Tufts Medicine & Tufts University School of Medicine** **Location:** Greater Boston, MA **Position ... and Tufts University School of Medicine invite applications for the Clinical Director of Women's Health and Longevity Program, that would include eligibility for… more
    Tufts Medicine (12/12/25)
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