- 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
- Point32Health (Canton, MA)
- … programs + Performs other roles/duties and projects as assigned by the Pharmacy UM Supervisor or Director **Qualifications** **- what you need to perform the ... leading not-for-profit health and well-being organization dedicated to delivering high- quality , affordable healthcare. Serving nearly 2 million members, Point32Health… 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