- 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 ... **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
- 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 (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
- Humana (Boston, MA)
- …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
- Sanofi Group (Cambridge, MA)
- **Early Pipeline Respiratory Medical Director ** **About Sanofi** At Sanofi, we are committed to the growth of our people, connected in purpose by career, life, ... millions of patients around the world. **Job Responsibilities:** + The Early Pipeline Respiratory Medical Director reports to the Global Medical Head of… more
- Sanofi Group (Cambridge, MA)
- …chronic dermatologic, respiratory, and gastrointestinal diseases. **Position Summary** + The Global Medical Director of Dermatology, 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 (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
- Humana (Boston, MA)
- …help us put health first** Humana Healthy Horizons is seeking an Associate Director , Medicaid Provider Services to serve in a strategic leadership role within ... Medicaid segment. The Medicaid Provider Services team, led by the Associate Director , is accountable for Humana's Medicaid segment strategy and operationalizing the… more
- South Middlesex Opportunity Council (Framingham, MA)
- …training and performance management . + In collaboration with the Medical Director , responsible for the design, development, implementation and ongoing ... SUMMARY The Clinic Director is responsible for ensuring the overall quality...Participate in quality improvement planning and action with entire management team. + Monitor caseloads and work with the… more
- Evolent Health (Boston, MA)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
- Takeda Pharmaceuticals (Lexington, MA)
- …strategies. + Provide product development and label development strategies to ensure promotional claims can be supported. + May provide management of individuals ... my knowledge. **Job Description** Join Takeda as an Associate Director , US Advertising & Promotion Regulatory Review out of...office. Where you will be working on the US Medical team, you will be empowered to serve as… more
- Sanofi Group (Cambridge, MA)
- **Job Title:** Director , Consumer Analytics **Location:** Cambridge OR Bridgewater **_About the job_** We are an innovative global healthcare company, committed to ... Sanofi hubs to optimize process excellence and efficiency The ** Director , Consumer Media Analytics NA** will be responsible for...Hub (ODH) across Sanofi NA. + Collaborate with Data Management & Digital teams to integrate and unify first-party,… more
- Sanofi Group (Cambridge, MA)
- **Job title** **_:_** Sr. Director , Insights and Analytics Tolebrutinib **Location:** Cambridge **Travel:** 10% **_About the job_** We are an innovative global ... from Sanofi hubs to optimize process excellence and efficiency The **Senior Director , Insights & Analytics: Tolebrutinib** is responsible for leading a team focused… more
- CVS Health (Boston, MA)
- …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
- J&J Family of Companies (Cambridge, MA)
- Director , Bladder Cancer, Solid Tumor, Oncology TA - 2406211554W **Description** Janssen Research & Development LLC (JRD), a Johnson & Johnson company, is recruiting ... for a Director , Bladder Cancer, Solid Tumor - Oncology Therapeutic Area...Familiarity with healthcare relevant datasets, such as EHR, insurance claims or registry data. + Prior experience working and… more
- 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
- Sumitomo Pharma (Boston, MA)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
- Takeda Pharmaceuticals (Boston, MA)
- …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
- Philips (Cambridge, MA)
- **Senior Director of Clinical Affairs** Delivers clinical knowledge, experience and expertise across the whole value chain from ideation to end-of-life. Focus in ... and existing products/ solutions for registration, adoption, market development and claims substantiation. + Support regulatory teams during the submission process.… more
- Evolent Health (Boston, MA)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more