- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The… more
- Sumitomo Pharma (Boston, MA)
- …marketed products. + Conduct safety surveillance over product life cycle, reviewing clinical trial and post-marketing Individual Case Safety Reports (ICSRs), ... on behalf of PVRM for: Study Protocols, Informed Consent Forms (ICF), Safety Management Plans (SMP), Clinical Study Reports (CSR), Investigator's Brochures (IB),… more
- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health + The curiosity… more
- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The… more
- Commonwealth Care Alliance (Boston, MA)
- …pre-certification functions to accomplish objectives within policy and budget. + Serve as a clinical resource and coach for the utilization management team + Is ... the utilization management team throughout the day to respond to clinical issues + Monitor utilization reports, identifying changes in utilization or access… more
- Humana (Boston, MA)
- …and experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by ... members of the Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including… more
- Evolent (Boston, MA)
- …impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... discussions with treating providers to ensure appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and … more
- Datavant (Boston, MA)
- …of service. This is a leadership role that combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be ... evolve and grow. **Key Qualifications** **Required** + 8+ years of product management experience in healthcare, including ownership of clinical , risk adjustment,… more
- Sevita (Dedham, MA)
- …staff; hire + Program Supervisors and Mentor Recruiters in consultation with Area Director ; approve hire of Program Services Clinical Coordinators and other ... annual Program Supervisor and Mentor Recruiter evaluations in consultation with Area Director ; review and approve annual Program Services Clinical Coordinator… more
- Sanofi Group (Cambridge, MA)
- …including trial protocols, informed consent forms, case report forms, risk management plans, training materials, clinical study reports, and publications. + ... Maintain deep knowledge of Alzheimer's disease pathophysiology, biomarkers, disease staging, clinical management , and drug development. + Contribute to biomarker… more