- Highmark Health (Boston, MA)
- …Inc. **Job Description :** **JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and ... **ESSENTIAL RESPONSIBILITIES** + Full-cycle ownership of commercial and Medicare Advantage medical policy creation process including writing clinical criteria… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Sanofi Group (Cambridge, MA)
- **Job Title:** Associate Director , Medical Value and Outcomes (Mid-Atlantic) **Location** : Remote/Field **About the Job** The Medical Value & Outcomes team ... and guidelines. + Facilitate scientific exchange, education and provides access to medical , health policy , and health economic information (eg, clinical… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …week, Monday - Friday Union: None Union Name: None Patient Facing: Yes The Associate Medical Director of Medical Respite, in close collaboration with the ... Medical Director , is responsible for the daily clinical operations of...real time, support front line staff and shape organizational policy and vision. This role is majority administrative with… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Boston, MA)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex...value based care in accordance with Medicare and Humana policy . All work occurs within a context of regulatory… more
- Veterans Affairs, Veterans Health Administration (Framingham, MA)
- …full time position in Boston, Massachusetts in vibrant and diverse clinics. The Medical Director is responsible for ensuring that excellent, high-quality care is ... and 49% administrative time. This person will be the Medical Director for the five VA Boston...meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months… more
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