- Datavant (Boston, MA)
- …in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding ... presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help...coding references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper coding or identify… more
- Commonwealth Care Alliance (Boston, MA)
- …of care and strategic objectives. The Manager fosters effective clinical and programmatic collaboration with provider partners, communicates performance expectations ... LTSS Program Manager ensures that providers meet contractual, regulatory, and quality standards that optimize member outcomes and operational efficiency. This role… more
- Bristol Myers Squibb (Devens, MA)
- …testing and data review for in-process, release, and stability testing of clinical and commercial cell therapy drug product. The Manager, QC Analytical will also ... execute a work plan for the shift, ensuring safety, quality , and performance targets are achieved. + Perform QC...and performance targets are achieved. + Perform QC data review ensuring results are compliant with specifications and regulations.… more
- Humana (Boston, MA)
- …are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs with a… more
- Humana (Boston, MA)
- …are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs with a… more
- Bristol Myers Squibb (Devens, MA)
- …stability strategy, stability program requirements, stability sample management, preparation, review and approval of stability reports and regulatory filings. The ... Action Fact Finding, and other investigations related to potential quality issues or capacity issues. + Accountable for stability...with a global mind-set to direct and influence multiple remote teams + Drives sense of team responsibility for… more
- Highmark Health (Boston, MA)
- …servicing quality dental networks in assigned territory in a remote and mobile work environment. Manage network contracts including negotiations, contract ... value added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site… more
- Parexel (Boston, MA)
- …responsible for site start-up, activation, relationship management, recruitment, and quality assurance. This role also contributes to site selection, provides ... issues, and collaborates with various functions to optimize communication, maintain site quality and patient safety utilizing data analytics to identify and mitigate… more
- Takeda Pharmaceuticals (Boston, MA)
- …and executes a labeling implementation plan to incorporate new scientific, safety and clinical data, as well as Health Authority responses / feedback into CCDS, USPI ... support to Local Affiliates for responses to health authorities requests, review of local labeling exceptions and alignment deferrals, etc. Escalation Process… more
- Humana (Boston, MA)
- …of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Exercises independent judgment and ... Medical Specialty + Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid… more