- Highmark Health (Boston, MA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Boston, MA)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Boston, MA)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Fallon Health (Worcester, MA)
- …and LinkedIn. **Brief summary of purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer ... of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM and represent the plan at clinical… more
- Humana (Boston, MA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **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
- Evolent (Boston, MA)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Humana (Boston, MA)
- …to the Lead Medical Director - North Central Medicaid Markets. 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 relies on medical background and reviews health claims. The … 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 ... **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 … more
- Boston Health Care for the Homeless Program (Boston, MA)
- …week, Monday - Friday Union: None Union Name: None Patient Facing: Yes The Associate Medical Director of Medical Respite, in close collaboration with the ... Medical Director , is responsible for the daily clinical operations of...5 years of clinical experience as an NP/PA required. Management experience is strongly preferred. DEA X-waiver required. +… more
- Sanofi Group (Cambridge, MA)
- …evidence-based disease management /health outcome initiatives, aligned with overall medical brand strategy. Director level MVO will develop strategic ... **Job Title:** Associate Director , Medical Value and Outcomes (Mid-Atlantic)...decision makers to facilitate scientific exchange on disease state management and the value of Sanofi Genzyme products, to… more
- Sanofi Group (Cambridge, MA)
- **Job title** : Medical Director , US Neurology, Multiple Sclerosis (MS) **Location** : Cambridge, MA **About the Job** In a matrix environment, the Medical ... in collaboration with his/her cross functional colleagues. The US Neurology Medical Director --CNS Inflammatory Diseases will also execute activities related… more
- ZOLL Medical Corporation (Chelmsford, MA)
- …innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and ... and respiratory conditions.The Acute Care Technology division of ZOLL Medical Corporation develops and delivers innovative lifesaving products and software… 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
- Fenway Health (Boston, MA)
- Medical Director of Primary Care Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Medical Job Type Full-time Description ... Reporting to the Chief Medical Officer (CMO), the Medical ...the DCEI to design and implement scheduling innovations, panel management systems, and alternative visit models. + Evaluates internal… 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 ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Takeda Pharmaceuticals (Boston, MA)
- …and analytical background, preferably in life sciences, and excellent project management skills. The Associate Director , Scientific Communications Lead, develops ... medical information, and/or training. + Experience with publications management databases such as Datavision + Working experience in cross-functional teams… more
- Evolent (Boston, MA)
- …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... utilization management while working in conjunction with the Senior Medical Director . **Qualifications** + MD/DO/MBBS Degree + Current, unrestricted clinical… more
- Edward M. Kennedy Community Health Center, Inc. (Framingham, MA)
- …right here in Central Massachusetts! Summary of opportunity: Reporting to the Chief Medical Officer, the Medical Director will provide leadership and ... Kennedy Community Health's Framingham MA primary care clinic. The Medical Director will spend part of their...+ Board Certified in Family Medicine + Knowledge of management and supervisory principles and practices. + 3-6 years… more
- Evolent (Boston, MA)
- …for utilization management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD/DO/MBBS Degree + ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key...Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- As a senior leader within Medical Affairs, the Executive Director will serve as a strategic thought partner and Chief of Staff to the Vice President of ... capabilities aligned with Otsuka's vision, direction, and growth strategy. The Executive Director , Medical Affairs Strategy, Excellence & Operations will lead… more