• Medical Director - Florida

    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 an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical more
    Humana (07/29/25)
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  • Medical Director - South Central

    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 an ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical more
    Humana (07/11/25)
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  • Medical Director - NorthEast Region

    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 an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical more
    Humana (07/25/25)
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  • Medical Policy Director

    Commonwealth Care Alliance (Boston, MA)
    …CCA-Central Clin Ops Leadership **Position Summary:** Reporting to the Sr. Medical Director of Utilization Management (UM) and Policy, the Medical ... services specific to the population serviced by CCA. The Medical Policy Director is an independent contributor...(nice to have):** + 10 years of experience in medical policy, utilization management , clinical… more
    Commonwealth Care Alliance (05/31/25)
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  • Utilization Review Medical

    Commonwealth Care Alliance (Boston, MA)
    023520 Clin Alli-Physicians Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review, the ... Utilization Review Medical Director will be responsible for providing leadership and subject... Utilization Review functions working closely with other medical management team members. + Support the… more
    Commonwealth Care Alliance (06/27/25)
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  • Manager Utilization Management

    Beth Israel Lahey Health (Burlington, MA)
    …taking a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for ... compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management . + Attends Mandatory Education programs required by… more
    Beth Israel Lahey Health (06/06/25)
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  • Manager, Utilization Management (RN)

    Evolent (Boston, MA)
    …with others. **Collaboration Opportunities:** + The Manager, Client Services oversees daily utilization management and directs the medical care of ... plans and serves in a supporting role to the Director , Intake and Utilization Management ...Utilization Management experience in a population management or managed care/insurance or hospital medical more
    Evolent (08/14/25)
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  • Director Case Management

    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...directing, and managing of the activities of the Case Management Program for Signature Healthcare & Signature Medical more
    Brockton Hospital (06/13/25)
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  • Medical Director , MSK Surgery

    Evolent (Boston, MA)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + ... Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a...practice of Orthopedic Spine Surgery is preferred. + Administrative Medical Experience- Utilization Management , Leadership… more
    Evolent (05/20/25)
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  • Field Medical Director

    Evolent (Boston, MA)
    …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management more
    Evolent (07/30/25)
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