- Daiichi Sankyo, Inc. (Boston, MA)
- …areas centered around rare diseases and immune disorders. Summary: The Associate Director Field Reimbursement (ADFR) is a critical front-line member of the DSI ... The primary purpose of this role is to serve as a field-based product access specialist that provides appropriate reimbursement support to HCPs to help facilitate… more
- Humana (Boston, MA)
- Humana Director , Actuarial of Medicaid Pricing - Boston, MassachusettsBecome a part of our caring community and help us put health firstThe Director , ... broad range of actuarial and business needs for specific product lines. The Director , Actuarial requires an...how organization capabilities interrelate across the function or segment.The Director , Actuarial of Medicaid Pricing may be… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range ... of actuarial and business needs for specific product lines. The Director , Actuarial requires an...organization capabilities interrelate across the function or segment. The Director , Actuarial of Medicaid Pricing may be… more
- WellSense (Boston, MA)
- …lead for the WellSense ACO and MCO programs under the Massachusetts Medicaid product known as MassHealth. WellSense's MassHealth enrollment includes >500k ... Director of Finance and Strategy, MassHealth Product...and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical… more
- CVS Health (Boston, MA)
- … Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and ... Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and… more
- Point32Health (Canton, MA)
- …are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, leading, ... key provider - facility and physician or group - clinical leadership. The Director oversees and leads medical management activities related to precertification… more
- Prime Therapeutics (Boston, MA)
- …and Account Management Staff). + Serves as Preferred Drug List product lead for program implementation including developing relationships, RFP support, and other ... drives every decision we make. **Job Posting Title** Sr Director , Value Based Pricing - Preferably on the West...+ 10+ years' professional experience in managed care and/or Medicaid . + 5+ years' experience in account management… more
- HealthEdge Software Inc (Boston, MA)
- …(National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other State ... support people need, when and where they need it. We call it Digital Health Management . Our comprehensive suite of Digital Health Management solutions for care … more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** Associate Director , Enterprise API Standards and Governance is a pivotal role in leading the technology ... transformation efforts focused on defining the product architecture standards and governance for API development across the enterprise. This role will bring together… more
- Prime Therapeutics (Boston, MA)
- …passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary** ... Medical Pharmacy Strategy. + Job Description + Supports overall Medical Pharmacy Product line for health plans through validated program enhancements, creation of… more
- WellSense (Boston, MA)
- …across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, ... their circumstances. **Job Summary:** The Senior Manager of Clinical Utilization Management (UM), Behavioral Health is responsible for the overall coordination and… more
