• Temporary, Utilization Review…

    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...preferred. + Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician more
    Commonwealth Care Alliance (08/20/25)
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  • RN System Director Utilization

    Tufts Medicine (Burlington, MA)
    …and identify areas for clinical documentation improvement. 14. In the absence of a Physician Advisor, the hospital Chief Medical Officer (CMO) will be consulted. ... Proven ability to run multi-disciplinary projects 4. Confident presenter to executives, physician committees, and payer medical directors 5. Skilled at writing… more
    Tufts Medicine (08/29/25)
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  • Manager Utilization Management

    Beth Israel Lahey Health (Burlington, MA)
    …risk patients admitted to the Clinic Attending Physicians: Coordinates appropriate documentation Medical Director for /Managed Care, Physician Advisors Works ... Management & review, HIM, Coding & Billing. Close collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee.… more
    Beth Israel Lahey Health (06/06/25)
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  • Medical Director - Florida

    Humana (Boston, MA)
    …and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, ... 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 (07/29/25)
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  • Field Medical Director , Cardiology

    Evolent (Boston, MA)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key... you will be a key member of the utilization management team. We can offer you a meaningful… more
    Evolent (08/15/25)
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  • Field Medical Director - Vascular…

    Evolent (Boston, MA)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key... you will be a key member of the utilization management team. We can offer you a meaningful… more
    Evolent (08/28/25)
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  • Field Medical Director , Pain…

    Evolent (Boston, MA)
    …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be... management while working in conjunction with the Senior Medical Director . May assist the Senior … more
    Evolent (08/20/25)
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  • Behavioral Health Medical Director

    Humana (Boston, MA)
    …may require conflict resolution skills. The Behavioral Health Medical Director may speak with contracted external physicians, physician groups, facilities, ... our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations.… more
    Humana (08/09/25)
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  • Field Medical Director , Oncology

    Evolent (Boston, MA)
    …timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...Oncology, you will be a key member of the utilization management team. We can offer you a meaningful… more
    Evolent (08/19/25)
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  • Field Medical Director , MSK Surgery

    Evolent (Boston, MA)
    …timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...Surgery you will be a key member of the utilization management team. We can offer you a meaningful… more
    Evolent (08/29/25)
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