• PCO Medical Director - UM - Part…

    CenterWell (Boston, MA)
    …a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical ... Director , Primary Care work assignments involve moderately complex to...ABQAURP, or other boarddemonstratingadvanced training in transitions of care, quality assurance,utilizationmanagementand care coordination. + A current and unrestricted… more
    CenterWell (11/06/25)
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  • Medical Director , Clinical Reviews

    Point32Health (MA)
    …not-for-profit health and well-being organization dedicated to delivering high- quality , affordable healthcare. Serving nearly 2 million members, Point32Health ... are at Point32Health (https://www.point32health.org/) . **Job Summary** The Medical Director , Clinical reviews will primarily perform utilization management and… more
    Point32Health (12/08/25)
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  • Clinical Pharmacist

    Point32Health (MA)
    … + Performs other roles/duties and projects as assigned by the Pharmacy UM Supervisor or Director **Salary Range** $107,921.67 -$161,882.51 **Compensation & ... leading not-for-profit health and well-being organization dedicated to delivering high- quality , affordable healthcare. Serving nearly 2 million members, Point32Health… more
    Point32Health (12/02/25)
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  • Physician Reviewer (Physician Review Unit)

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …with treating providers, as appropriate. At the request of the Senior Medical Director of the Physician Review Unit (PRU), the reviewer also provides clinical ... determination depends, making reasonable efforts to obtain relevant information via UM clinical reviewers, peer-to-peer outreach, and/or direct provider EMR access,… more
    Blue Cross Blue Shield of Massachusetts (12/10/25)
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