- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and… more
- Commonwealth Care Alliance (Boston, MA)
- …the organization. The Medical Policy Director ensures that the medical policies align with the organization's clinical and operational goals, meet ... Clin Ops Leadership **Position Summary:** Reporting to the Sr. Medical Director of Utilization Management (UM) and...Manage the development of new and review of existing medical necessity guidelines by working closely with clinical… more
- Datavant (Boston, MA)
- …to deliver complex healthcare technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models (eg, ... requirements, medical record standards, and regulatory guidance impacting concurrent coding or risk adjustment. + Product experience integrating into EHRs or… more
- Sumitomo Pharma (Boston, MA)
- …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... Serious Adverse Event Reports (SAEs), and Product Complaints (PCs) + Contributes to medical safety of clinical trials, including monitoring of clinical … more
- East Boston Neighborhood Health Center (East Boston, MA)
- …Position Summary/Responsibilities: In collaboration with Adult Medicine leadership team, the Medical Director is responsible for * collaborating closely with ... communication amongst leadership and departmental staff * administrative and clinical development of medical staff in Adult... coding and billing departments to assure proper coding . * providing real-time clinical consultation for… more
- CVS Health (Boston, MA)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...for predetermination reviews ad reviews of claim determinations, providing clinical , coding , and reimbursement expertise, using multiple… more
- East Boston Neighborhood Health Center (MA)
- …policies, procedures, and patient education materials in collaboration with the Medical Director (s). 3.Facilitates in collaboration with the BH Leadership ... to the IT Epic training team as indicated. 4.In collaboration with the BH Medical Director , designs and implements the BHC and Psychiatric provider orientation… more
- Beth Israel Lahey Health (Burlington, MA)
- …best practices are followed in patient care, documentation, coding , and medical record maintenance. 4. Collaborate with clinical teams to monitor workflows, ... with Medical Leadership, and reports directly to the Executive Director . **Job Description:** **Essential Duties & Responsibilities** including but not limited… more
- Sanofi Group (Cambridge, MA)
- … Director will demonstrate strong relationships with Trade/Industry Relations, Medical and Pharmacy Directors ( clinical and administrative), Case Managers, ... **Job Title:** Regional Account Director , New England North **Location:** Remote/Field Based **About...Demonstrated knowledge of payer decision-making for formulary processes, coverage, coding and patient access to drugs, biologicals, medical… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …corrective actions. + **Training and Education:** Develops curriculum and delivers clinical documentation, coding and billing education programs for physicians, ... dotted line reporting relationship to the VP, Revenue Performance Management, the Director of Billing Compliance ensures the integrity and accuracy of billing… more