- 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
- 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
- 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
- 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 (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 (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
- 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
- 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 (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 you will be a key... you will be a key member of the utilization management team. We can offer you a meaningful… more
- Brockton Hospital (Brockton, MA)
- …with the physician advisor to proactively intervene in cases where utilization of resources is sub optimal. Aggregates information for an array of audiences ... PURPOSE OF POSITION: The Director of Case Management is responsible for planning,...and provides mission critical access to Hospital & Signature Medical Group. Collaborates with all disciplines with a specific… more