- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Boston, MA)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- Cognizant (Boston, MA)
- **About the role** **Schedule:** M-F **Traveling Required:** 40% As a Medicaid Eligibility Delivery Director , you will make an impact by overseeing access, ... wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in United States. Regardless of your… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other...7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical… more
- Evolent (Boston, MA)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Boston, MA)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Boston, MA)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Boston, MA)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- CenterWell (Boston, MA)
- **Become 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical … more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...+ Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider ... network performance, and ensuring compliance with regulatory standards. The Director drives initiatives that enhance operational engagement, member access, provider… more
- Merck (Boston, MA)
- **Job Description** Associate Director , Field Access Management The Associate Director , Field Access Management serves as the leader to a team of subject-matter ... Management Team for which you are responsible. * Understand Regional Payor and Medicaid coverage and provide market access education via approved materials to the… more
- Humana (Boston, MA)
- …our caring community and help us put health first** The Associate Director , Finance Data Management supports all aspects of configuration control, data management, ... and deficiency reporting. The Associate Director , Finance Data Management requires a solid understanding of...PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Humana (Boston, MA)
- …our caring community and help us put health first** The Director , General Accounting performs general accounting activities, including the preparation, maintenance ... Conducts or assists in the documentation of accounting projects. The Director , General Accounting requires an in-depth understanding of how organization capabilities… more
- Sumitomo Pharma (Boston, MA)
- …a dynamic, highly motivated, and experienced individual for the position of Associate Director , Market Access Engagement - Rare Disease, who will act as the face ... various payers (commercial and government payers to include FFS and Managed Medicaid ) and remove reimbursement barriers to treatment + Build and maintain strong… more
- Takeda Pharmaceuticals (Boston, MA)
- …and be empowered to deliver your best. In this highly visible role, the Sr. Director will lead the strategic and analytic aspects of the US Oncology BU's (US OBU's) ... lead the newly formed health economics function. The Sr Director will develop the analytic aspects of the US...-- Department of Veterans Affairs (VA), Federal SupplySchedule (FSS), Medicaid , Department of Defense (DOD) -- and OncologyGPOs. This… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …**Job Description** **About the role:** As Counsel, Market Access, at the senior director level, you will be responsible for providing day-to-day legal support to ... GPOs, the Department of Veterans Affairs (VA), Federal Supply Schedule (FSS), Medicaid , the Department of Defense (DOD), specialty pharmacies and distributors. +… more
- Danaher Corporation (Boston, MA)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE ) position is a provider / customer facing role responsible for ... to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the...Value and Access team. This position will be a remote position ideally located in the Eastern part of… more