- Fallon Health (Worcester, MA)
- … to identify and prioritize the cost of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM ... strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care,… more
- Humana (Boston, MA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Boston, MA)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- CenterWell (Boston, MA)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
- East Boston Neighborhood Health Center (East Boston, MA)
- …and procedures along with the Administrative Director + Oversees Clinical Quality Management and Utilization Management of the department along with the ... Washington Street, 20 Maverick Square - Cradock Building Position Summary: Dental Director of NeighborHealth Working under general supervision of the Chief Medical… more
- South Middlesex Opportunity Council (Framingham, MA)
- …casual Working Conditions: As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or incidental contact with ... children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. Candidates must… more
- Brockton Hospital (Brockton, MA)
- PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management Program ... solves problems, referring exceptional issues to Vice President. The Director of Case Management is responsible for...enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management… more
- Evolent (Boston, MA)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with… 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 ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more