- Commonwealth Care Alliance (Boston, MA)
- …billing-related certifications **Required Experience (must have):** + 3+ years in healthcare claims processing, provider reimbursement, or payment integrity. + ... states will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr.… more
- CVS Health (Wellesley, MA)
- …and key performance metrics for reconciliation, revenue cycle, and adjudication/ claims processes analysis. Facilitate effective solutions related to adjudication and ... processing of pharmacy and vaccine/medical claims , maintaining current services, support optimalization of existing vendor product portfolio, provide continual… more
- Norstella (Boston, MA)
- Sr. Director , RWD Analytics and Innovation ( Healthcare & Life Sciences) Company: Norstella Location: Remote, United States Date Posted: Jul 30, 2025 Employment ... India. **Job Description :** We are seeking a dynamic and visionary Senior Director of RWD (Real-World Data) Analytics and Innovation to lead real-world data special… more
- Kyndryl (Boston, MA)
- …a key leadership role across multi-disciplinary teams, guiding them through complex consulting engagements and be responsible for creating and positioning strategic ... Kyndryl's largest accounts across the C-suite, spanning the intersection between complex Business and IT customer solutions, transformations that impact across the… more
- Humana (Boston, MA)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Humana (Boston, MA)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Ophthalmic Consultants of Boston (Plymouth, MA)
- …passionate about revenue cycle innovation, team development, and operational excellence in a complex healthcare environment. Why Join OCB? OCB has a longstanding ... Join a Leader in Eye Care: Director of Revenue Cycle & Billing at Ophthalmic...hands-on leader ready to take charge of high-volume, multi-department healthcare operations? Ophthalmic Consultants of Boston (OCB), a nationally… more
- Evolent (Boston, MA)
- …Management** and **Product Management** , leveraging advanced analytics to solve complex healthcare challenges and support impactful decision-making that ... Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Evolent (Boston, MA)
- …or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...+ At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- Sanofi Group (Cambridge, MA)
- **Job title** : Global Medical Director , Evidence Generation - Innovation & Partnerships **Location:** Cambridge, MA, Morristown, NJ **About the Job** Sanofi's ... and best in class therapeutic solutions that address highest unmet needs. The Director for medical epidemiology and RWE in the Next-Gen Immunology franchise will act… more