- Point32Health (Canton, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director, Utilization Management is responsible for directing, leading, and ... modifying the business processes and operations for all levels of utilization management review (ie, Precertification and Intake Services, Inpatient &… more
- WellSense (Boston, MA)
- …that works for our members, no matter their circumstances. **Job Summary:** The Senior Manager of Clinical Utilization Management (UM), Behavioral Health ... improvement of existing department policies and procedures and works with department senior management for implementation; follows through with evaluation. +… more
- CVS Health (Boston, MA)
- … in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds to ... programs and commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy revisions/reviews. - Directors… more
- Evolent Health (Boston, MA)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Reviewer you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent Health (Boston, MA)
- …Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Tufts Medicine (Boston, MA)
- …development. **Job Overview** This position is accountable for service line management , leading strategic, financial, and operational aspects of the Service Lines. ... Service Lines, excellence in patient access and care, and effective financial management . **HOW YOU'LL MAKE A DIFFERENCE:** Through operational and data analysis,… more
- Tufts Medicine (Boston, MA)
- …operations and remove operational barriers. You'll be responsible for operational management , budget and financial management , quality assurance and compliance, ... the Department, excellence in patient access and care, and effective financial management . **Job Overview** This position is accountable for service line … more
- Air Force Materiel Command (Hanscom AFB, MA)
- …projects or portions of larger projects and programs under the guidance of a senior engineer. The incumbent must apply judgment in the independent application of the ... mechanics, flight dynamics, flight structures, propulsion, thermodynamics, and energy conversion/ utilization to aerospace vehicles and related equipment. Researches, analyzes,… more
- Brockton Hospital (Brockton, MA)
- …with Chief Medical Officer (CMO). Develops systems to ensure optimal therapeutic drug utilization . Anticipates and creates plans to manage new drug costs and supply ... policies, state and federal regulations for all pharmacy locations, and accreditation body requirements, including Department of Public Health (DPH), Board of… more