- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
- CBRE (Boston, MA)
- Business Development Senior Director , Enterprise Occupier Solutions Job ID 208590 Posted 28-Feb-2025 Service line GWS Segment Role type Full-time Areas of ... Director , Business Development** We are seeking a Senior Director , Business Development & Client Solutions...same for direct reports to next level management for review and approval. Monitors appropriate staffing levels and reports… more
- Prime Therapeutics (Boston, MA)
- …and drives every decision we make. **Job Posting Title** Clinical Solutions Strategy Senior Director - Remote **Job Description** The Clinical Solutions Strategy ... Senior Director is responsible for developing new,...and implementation of innovative drug solutions, including optimizing drug utilization , patient outcomes, and cost-effectiveness through value-based care models,… more
- Tufts Medicine (Burlington, MA)
- …in the Clinical Documentation Integrity (CDI), Coding, HIM Operations, and Utilization Review (UR) departments while implementing enterprise-wide vision. The ... are heard and facilitate a plan for resolution. Responsibilities under CDI & Utilization : 1. Accountability for success of the CDI program; track and trend… 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, ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** + MD/DO/MBBS Degree + Current, unrestricted… 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, ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD/DO/MBBS-… 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, ... for utilization management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD/DO/MBBS… more
- Humana (Boston, MA)
- …role, you will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus ... The Director , Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director team… more
- Commonwealth Care Alliance (Boston, MA)
- 013390 CCA-Clinical Performance **Position Summary:** The Director of Clinical Performance Improvement, reporting to the Sr Director , Clinical Operations and ... Duties & Responsibilities:** + Actively monitor health plan medical expense, utilization , and unit cost year over year trends, performance against targets,… more
- Evolent (Boston, MA)
- …overall accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more