- 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...leadership and subject matter expertise to our utilization management ( UM ) group. This role is a key role in… more
- Tufts Medicine (Burlington, MA)
- …program strategy and oversight. The Director will partner with the Senior Director , Clinical Revenue Cycle to strategically plan, organize, implement, and ... multiple revenue cycle and hospital departments, such as Coding, Utilization Management ( UM ), Case Management, Quality and Physician advisors and leaders. The … more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …various levels in the organization + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... healthcare? Bring your true colors to blue. The Role:The Medical Clinical Program Manager will focus on utilization management...key issues/ risks and meet deadlines + Collaborate with Director and Senior Program Managers to identify/… more