- 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Scientist supports analytic activities associated with BCBSMA overall performance on Medicare Stars ratings, with specific focus on CAHPS patient experience ... to help identify the most efficient means through which Medicare Stars clinical quality and patient experience performances at...into a cohesive view. Under direction of the Senior Director of Population Health Analytics, the Data Scientist will… more
- CVS Health (Boston, MA)
- …and affordable. **Position Summary** As the Manager, FP&A, you will report directly to Director of Finance and will monitor the end to end profit & loss statements, ... data submission for the purpose of rate setting and medical trend analysis on behalf of the Health Plan....nature of this remote role, candidates must have some Medicare and/or Medicaid experience. **Required Qualifications** -5 or more… 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 ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… 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)
- **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Beth Israel Lahey Health (Charlestown, MA)
- …government reimbursement and net revenue analysis. Working with the VP and AVP, the Director will develop long- and short- term Medicare , Medicaid, and other ... not just taking a job, you're making a difference in people's lives.** The Director , Revenue Finance and Reimbursement, will be a core member of the Revenue Finance… more
- Evolent (Boston, MA)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Boston, MA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- CVS Health (Boston, MA)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... Management staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for… more
- Advocates (Framingham, MA)
- …that values the ideas and contributions of our staff. The Behavioral Health Regional Medical Director (RMD) is a leadership and clinical role within Advocates' ... Behavioral Health Services Division. The RMD serves as Medical Director for the clinics of an...from the National Practitioner Data Bank and absence of Medicare /Medicaid sanctions. + Currently practicing a minimum of 20… more
- Evolent (Boston, MA)
- …$64M of savings for Medicare in the Shared Savings Program. The Managing Director will report to the SVP Primary Care / President of Evolent Care Partners and ... Medicare and Commercial contracts, including plans related to medical expense management, quality improvement, appropriate risk adjustment, and patient and… more
- Athena Health Care Systems (Marlborough, MA)
- We are hiring an MDS Director to join our dynamic care team at Marlborough Hills Rehabilitation & Health Care Center in Marlborough! Working with our team and ... you to grow within the company. As the MDS Director , you plan, organize, and direct the MDS process...resident care plans through clinical assessment, review of resident's medical history, personal interviews, and completion of MDS reports.… more
- Tufts Medicine (Boston, MA)
- …support to the Associate CMO for Graduate Medical Education, TM Entity Medical Education Physician Leaders and the Director of Simulation, as needed. This ... Education (OCE) at Tufts Medicine oversees the following components: Graduate Medical Education, Undergraduate Medical Education, Physician Assistant Education… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Associate Director , Actuarial provides actuarial support across a broad range of actuarial and business ... needs for specific product lines. The Associate Director , Actuarial requires a solid understanding of how organization capabilities interrelate across department(s).… more
- HCA Healthcare (Derry, NH)
- …is incentive eligible. **Introduction** Do you have the career opportunities as a Director of Oncology you want with your current employer? We have an exciting ... opportunity for you to join Parkland Medical Center which is part of the nation's leading...of colleagues. Do you want to work as a(an) Director of Oncology where your passion for creating positive… more
- Humana (Boston, MA)
- …our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing architectures and ... and unstructured data to insights at enterprise scale. The Associate Director , Cloud Architecture requires an in-depth understanding of how organization capabilities… more
- United Therapeutics (Boston, MA)
- …orphan diseases. **How you'll contribute** The Associate Analytics, Insights and Operations Director , Market Access will lead data support across all functions of ... Compliance, Legal, Information Technology, Sales & Marketing Operations, Finance, and Medical Affairs / HEOR. Additionally, this role will support special pricing… more
- Pfizer (Cambridge, MA)
- ** Director , US Market Access Marketing Oncology, Sasanlimab and Mevrostat** **ROLE SUMMARY** The incumbent, within the US Market Access Marketing (USMA-M) team, will ... development of the Customer/Brand engagement strategy for top accounts within Commercial, Medicare , and other channels as appropriate based on clinical and economic… more
- Sumitomo Pharma (Boston, MA)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Pricing and Contracting.** This position reports to the **Executive ... Director , Pricing, Contracting & Policy** . The ** Director...analytics and financial modeling + Understanding of Commercial and Medicare Part D pharmacy benefit designs + Understanding of… more