• Medical Director -- Claims

    Humana (Providence, RI)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (10/29/24)
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  • Healthcare Medical Claims Coding Sr.…

    Commonwealth Care Alliance (Boston, MA)
    …under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for...and Analytics + Direct and relevant experience with HCFA/UB-04 claims management , coding rules and guidelines, and… more
    Commonwealth Care Alliance (10/17/24)
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  • Medical Director

    Genesis Healthcare (Cumberland, RI)
    …or on call)! We are seeking a full-time (40 hours per week) Attending Physician/ Medical Director for our Grandview Center, located in Cumberland, RI. The annual ... salary for this position is $215000 / year. This is a Dual Role Attending Physician/ Medical Director . This role is clinical in nature. Must be BC/BE Internal… more
    Genesis Healthcare (09/20/24)
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  • Medical Director - National Medicare…

    Humana (Providence, RI)
    management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
    Humana (11/08/24)
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  • Director , Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical health ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting strategic… more
    Commonwealth Care Alliance (09/19/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Providence, RI)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (10/29/24)
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  • Global Medical Director , Early…

    Sanofi Group (Cambridge, MA)
    **Global Medical Director , Early Pipeline Respiratory, Global Medical Immunology** **About Sanofi** At Sanofi, we are committed to the growth of our people, ... millions of patients around the world. **Job Responsibilities:** + The Early Pipeline Respiratory Medical Director reports to the Global Medical Head of… more
    Sanofi Group (09/14/24)
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  • Global Medical Director , Early…

    Sanofi Group (Cambridge, MA)
    …and gastrointestinal diseases. **Main Responsibilities:** The Early Pipeline Gastroenterology Associate Medical Director reports to the Global Medical ... will closely collaborate with cross-functional teams, develop, and execute asset medical plans, support lifecycle management activities, and integrate… more
    Sanofi Group (09/14/24)
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  • Global Medical Immunology Pipeline…

    Sanofi Group (Cambridge, MA)
    …dermatologic, respiratory, and gastrointestinal diseases. **Main responsibilities:** + The Global Medical Director of Rheumatology, reports to the Global ... will closely collaborate with cross-functional teams, develop, and execute asset medical plans, support lifecycle management activities, and integrate… more
    Sanofi Group (09/14/24)
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  • HVDC Project Director

    GE Vernova (Foxborough, MA)
    …Plan. Ensures best compliance with specification at lowest final cost. + Claim Management : define the strategy for managing claims and directs actions ... HVDC Solutions. In this context, Grid Solutions is looking for a Project Director who will be responsible for project on-time delivery, profit & loss accountability,… more
    GE Vernova (10/26/24)
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  • Director , Finance & Accounting- Affordable…

    Robert Half Finance & Accounting (Dedham, MA)
    Description Our client, a premier company in the Senior Care field, is seeking a Director of Finance. The Director of Finance is a key member of the leadership ... in presentations to various committees and boards. Additionally, the Director of Finance oversees all financial activities, including accounting, reporting,… more
    Robert Half Finance & Accounting (10/23/24)
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  • Associate Director , Access and Patient…

    Cardinal Health (Providence, RI)
    …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
    Cardinal Health (11/14/24)
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  • Client Services Director - Casualty | CST…

    Sedgwick (Providence, RI)
    …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | CST & EST Time Zones...EST Time Zones **PRIMARY PURPOSE** : To determine account management strategies related to client service plans; to be… more
    Sedgwick (11/12/24)
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  • Executive Director , Claim Platform Quality…

    CVS Health (Woonsocket, RI)
    …in new and exciting ways every day. Aetna is recruiting for an Executive Director , Claim Platform Quality Assurance for the Claims Center of Excellence ... CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and… more
    CVS Health (10/29/24)
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  • Assistant Director of Human Resources

    Robert Half Finance & Accounting (Boston, MA)
    Description **Assistant Director of Human Resources** Our client is looking for a proficient Assistant Director of Human Resources to join the team and assist ... and employee relations, ensuring legal compliance, and responding to any employee-related claims . In addition, you will be expected to work harmoniously with… more
    Robert Half Finance & Accounting (10/17/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Providence, RI)
    …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
    Takeda Pharmaceuticals (10/16/24)
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  • Director , Global Labeling Strategy Lead

    Takeda Pharmaceuticals (Cambridge, MA)
    …plasma-derived therapies for patients with immunologic, hematologic, and other complex diseases. The Director , Global Labeling Strategy Lead is a key role in the PDT ... new TLP, CCDS, USPI and EU SmPC. **How you will contribute:** ** Management of Labeling Cross-Functional Teams** + Leads Labeling cross-functional teams providing… more
    Takeda Pharmaceuticals (11/09/24)
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  • Director of Salesforce Platform

    Manulife (Boston, MA)
    …particularly Salesforce. + Business process expertise in Sales and Distribution, Operations, Claims Management , and Customer Service preferred. + More than 5 ... John Hancock seeks an experienced Director of Platform - Salesforce to lead and...delivery to support business objectives. Strong leadership and people management skills are essential. **Key Responsibilities:** Strategic Leadership of… more
    Manulife (10/26/24)
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  • Associate Director , Data Governance…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …us transform healthcare? Bring your true colors to blue. What We Need The Associate Director of Data Governance & Analytics Success will be a key leader in executing ... governance functions. + Implement technology solutions to enable robust data lifecycle management , improve data quality and standards, and self service analytics. +… more
    Blue Cross Blue Shield of Massachusetts (08/27/24)
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  • Operations Supervisor - Move Management

    HomeSafe Alliance (Providence, RI)
    **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
    HomeSafe Alliance (10/02/24)
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