- Evolent (Boston, MA)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Highmark Health (Boston, MA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… 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 ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … 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 ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Humana (Boston, MA)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Boston, MA)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Boston, MA)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Commonwealth Care Alliance (Boston, MA)
- …UM staff, including nurse reviewers and support personnel. * Act as liaison with medical director , provider relations, case management and quality teams to ... and organizational determinations. Essential Duties & Responsibilities: The Manager, Utilization Management reports to the Director of Utilization Management… more
- Takeda Pharmaceuticals (Lexington, MA)
- …of my knowledge. **Job Description** About the role: Join Takeda as an Associate Director , US Medical Neuroscience (Orexin) where you will serve in a critical ... more products, and supports the development, and ongoing updates to relevant product-specific medical strategies, in partnership with Sr. Director , Director … more
- Boston Health Care for the Homeless Program (Boston, MA)
- …week, Monday - Friday Union: None Union Name: None Patient Facing: Yes The Associate Medical Director of Medical Respite, in close collaboration with the ... Medical Director , is responsible for the daily clinical operations of...5 years of clinical experience as an NP/PA required. Management experience is strongly preferred. DEA X-waiver required. +… more
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