- Harbor Health Services, Inc. (Mattapan, MA)
- …We are currently seeking a Director of Utilization Management & Quality Programs . Harbor Health offers an excellent, comprehensive benefits package including ... Programs of All-Inclusive Care for the Elderly, a program that allows frail elders to live in their...Operations, the Director of Utilization Management and Quality Programs is responsible for the day-to-day… more
- 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
- 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
