- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, ... the business processes and operations for all levels of utilization management review (ie, Precertification and Intake...leadership. The Director oversees and leads medical management activities related to precertification utilization … more
- CVS Health (Boston, MA)
- …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and… more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... skills, with prior experience participating in teams focusing on quality management , utilization management , and acute inpatient rehabilitation… more
- Humana (Boston, MA)
- …opportunities are addressed. They will work closely with established functions inside utilization management (Medical Director , clinician decision making ... verbal communication **Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP)… more
- Beth Israel Lahey Health (Burlington, MA)
- …Advisor will play an active role in optimizing healthcare resource utilization , ensuring quality, patient care, and managing valuable organizational resources. The ... of multidisciplinary teams-Nursing staff leadership, hospitalist and closely collaborates with the director of care transitions to assess and guide the appropriate … more
- Evolent Health (Boston, MA)
- …and Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Associate Director and Director may ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
- Clean Harbors (Norwell, MA)
- Clean Harbors is looking for a ** Director of Fleet Asset Management ** to join our safety conscious team! The Director will provide leadership for the overall ... management of the Company's key asset classes. Lifecycle management responsibilities include asset acquisition and justification, asset deployment, designing and… more
- Evolent Health (Boston, MA)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a...department, you will be a key member of the utilization management team. We can offer you… more
- CVS Health (Boston, MA)
- …care more personal, convenient and affordable. **Position Summary** The Lead Director of Observability Governance is responsible for leading strategic planning for ... to meet the needs of all CVS Health businesses. As a Lead Director of Observability Governance, you will collaborate with observability engineering and operations… more
- Marriott (Boston, MA)
- …United States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** The Director of Privileged Access ... as a service (IDaaS) platform + Graduate/post graduate degree **CORE WORK ACTIVITIES** + Director role focused on Privileged Access Management + This function is… more
- Marriott (Boston, MA)
- …and not by Marriott International, Inc. JOB SUMMARY: The remote role of the Director Revenue Management is to provide direction to property teams to identify ... **Job Number** 24136294 **Job Category** Revenue Management **Location** Laguna Cliffs Marriott Resort & Spa,...RESPONSIBILITIES: * Collaborate with the General Manager (GM) and Director of Sales (DOS) to set and manage yield… more
- Humana (Boston, MA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- Takeda Pharmaceuticals (Boston, MA)
- …to bring life-changing therapies to patients worldwide. Join Takeda as an Associate Director , Portfolio Management Lead where you will ensure that the PharmSci ... and strategic support on high-priority, complex, cross-functional program and portfolio management initiatives. As part of the PS Program Leadership, you will… more
- CVS Health (Boston, MA)
- …advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management ... will be responsible for provider education regarding best clinical practices, utilization management , care management , claims adjudication, pharmacy … more
- The Home for Little Wanderers (Walpole, MA)
- …development and enhanced productivity. Administer the performance evaluations and performance management process. + Assist the Director of Clinical Services ... for an up to $5000 sign-on bonus!** Assist the Director of Clinical Services by providing clinical supervision for...level and maintain a small caseload. + Maintain the utilization review process. Ensure quality assurance standards are met… more
- Beth Israel Lahey Health (Burlington, MA)
- …healthcare services. Leverage health informatics and data analytics across campuses The Director will oversee the integration and utilization of health ... taking a job, you're making a difference in people's lives.** The Institute Director will develop the strategic plan, research priorities, and recruit and build a… more
- Daiichi Sankyo Inc. (Boston, MA)
- …national payer landscapes with expertise in formulary decisions, reimbursement policy, utilization management criteria, prior authorization processes and appeal ... areas centered around rare diseases and immune disorders. **Summary:** The Associate Director Field Reimbursement (ADFR) is a critical front-line member of the DSI… more