- Humana (Boston, MA)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care … more
- Athena Health Care Systems (Sandisfield, MA)
- We are hiring a Director of Social Services to join our dynamic care team at Berkshire Rehabilitation & Skilled Care Center in Sandisfield! Berkshire Rehab ... individuals, regardless of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and… more
- Sanofi Group (Cambridge, MA)
- …organizations, as well as initiatives with other large and local managed care organizations. The Regional Account Director is expected to work with minimal ... **Job Title:** Regional Account Director , New England North **Location:** Remote/Field Based **About...accounts. Efforts will include working with national headquarters of managed care organizations and leading pull-through strategies… more
- Humana (Boston, MA)
- …management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy. The… more
- State of Massachusetts (Boston, MA)
- …collaboration with staff from the Health Care Access Bureau and Bureau of Managed Care to advise the Commissioner about issues that may impact future ... evaluate the medical necessity and appropriateness of requested health care services. The primary purpose of the Director...market that have implications in health insurance mandates and managed care practices. * Manage staff working… more
- Beth Israel Lahey Health (Boston, MA)
- …the timeliness, accuracy, and integrity of health information to support patient care , revenue cycle, and organizational goals. The Director will interpret ... you're making a difference in people's lives.** Under oversight of the Executive Director , the Director , HIM Operations is responsible for leading efficient… more
- Grifols Shared Services North America, Inc (Fall River, MA)
- …presentations to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and ... more than 110 countries and regions. The primary responsibility of the MSL Field Director is the management, performance, and coaching of a team of MSL direct… more
- Bear Mountain Health Care (Worcester, MA)
- …Functions . Ensure proper respiratory staffing 24/7 . Educate staff on Medicare/ Managed Care /Medicaid guidelines documentation . Monitor all dept documentation ... and all Clinical policies and Procedures. Provides quality resident care to enable the residents to achieve and maintain...center meetings including but not limited to QAPI and Care Plan meetings. . Review Vent and Trach referrals… more
- Point32Health (Canton, MA)
- …implement new opportunities to reduce medical/administrative costs and enhance the quality of care related to ancillary health services. The Director also has ... **EXPERIENCE** (minimum years required) **:** + 10+ years related experience in a managed health care environment, with a thorough knowledge of the health… more
- Takeda Pharmaceuticals (Boston, MA)
- …MD, NP or DMP/ARNP, etc). + Seven (7) years of post-doctoral healthcare, pharmaceutical or managed care experience; or Managed Care / HEOR fellowship with ... Join Takeda as a Regional Account Medical Lead (Associate Director ) where you will work with Account Management (AM)...two years post-doctoral healthcare, pharmaceutical or managed care experience. + One (1) year… more