• Medical Policy Director

    Commonwealth Care Alliance (Boston, MA)
    …Medical Director of Utilization Management (UM) and Policy , the Medical Policy Director , provides strategic and tactical leadership and oversight ... of health services specific to the population serviced by CCA. The Medical Policy Director is an independent contributor who works in partnership… more
    Commonwealth Care Alliance (08/31/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …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...in complex or difficult case + Ensure compliance with medical policy . Maintains compliance with all federal,… more
    Commonwealth Care Alliance (09/05/25)
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  • RN Medical Policy Specialist

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …meeting, provide comparative market analysis and literature reviews for Medical Director . + Represent Medical Policy Administration in various divisional ... help us transform healthcare? Bring your true colors to blue. Job Description: The Medical Policy Specialist reports to the leader of Medical Policy … more
    Blue Cross Blue Shield of Massachusetts (08/19/25)
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  • Behavioral Health Medical Director…

    Humana (Boston, MA)
    …audit, grievance and appeal and policy review. The Behavioral Health Medical Director will develop and present educational seminars on various behavioral ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...at large. ​ **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (08/09/25)
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  • Medical Director - Southeast Region

    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 (09/10/25)
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  • Director , Medical Staff Office…

    Beth Israel Lahey Health (Woburn, MA)
    …medical staff support, and ensure system standards are consistently upheld. + **Department Medical Director ** - Partners with the medical leadership of ... taking a job, you're making a difference in people's lives.** The System Medical Staff Office (MSO) Director provides strategic and operational leadership for… more
    Beth Israel Lahey Health (07/21/25)
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  • Medical Director - OneHome

    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
    Humana (08/25/25)
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  • National Accounts Medical Director

    Elevance Health (Woburn, MA)
    **National Accounts Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable...law. Alternate locations may be considered. The **National Accounts Medical Director ** is responsible for serving as… more
    Elevance Health (08/27/25)
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  • Medical Director - Acute Rehab Team

    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 ... knowledge in their daily work specifically for DSNP. The Medical Director 's work includes computer-based review of...at large. ​ **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (09/11/25)
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  • Medical Director - Northeast Region

    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 (07/25/25)
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