- Highmark Health (Boston, MA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Boston University (Boston, MA)
- …and creates practical, scalable solutions for a growing and evolving team. The Director will blend project management fundamentals with strategic thinking and ... ** DIRECTOR , CAMPAIGN OPERATIONS, ADVANCEMENT, Development & Alumni Relations**...who will be instrumental in designing and implementing project management processes, documenting workflows, and establishing standards for campaign… more
- East Boston Neighborhood Health Center (MA)
- …services, IBH, Specialty, and all other clinical programs assigned. 18.Provides programmatic management and oversight of access and utilization data to the ... Summary: Under the direction of the Chief Behavioral Health Officer, the Administrative Director is an agent of change who oversees the overall clinical quality and… more
- Evolent (Boston, MA)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management team. We can offer you a… more
- Humana (Boston, MA)
- …+ Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices **Work Schedule Monday - Friday w/standard ... hospitals/ Integrated Delivery Systems, health insurance, or other healthcare providers. + Utilization management experience in a medical management review… more
- State of Massachusetts (Boston, MA)
- …Division of Insurance values inclusiveness and diversity within their employee and management teams. Within our community we strive to create and maintain working ... their skills and talents to serve our citizens. *_About the Role:_* The Director of Pharmacy Benefit Manager Oversight operating within the Health Care Access Bureau… more
- Humana (Boston, MA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience… more
- Manulife (Boston, MA)
- …Join Manulife's Audit and Advisory Services team, where we partner with management to enhance risk control and organizational resilience. We deliver insightful ... reports to senior management and the Board, reinforcing our commitment to excellence...data quality within Archer. + Lead the department's effective utilization of the Archer. Champion initiatives to enhance and… more
- Tufts Medicine (Boston, MA)
- …the VP of the Cancer Service Line for Tufts Medicine, the Executive Director is accountable for operations, financial performance, and strategic execution for the ... compliance, and deliver high-quality, patient-centered care. Additionally, the Executive Director will support specialized services including CAR-T, Gamma Knife,… more
- Beth Israel Lahey Health (Needham, MA)
- …regulatory equipment are met and/or exceeded. Optimal patient care and cost effective management is maintained through utilization of data and information from ... making a difference in people's lives.** Job Summary: The nurse director provides 24-hour operational accountability for his/her unit(s). Collaborates with the… more