• PCO Medical Director - UM - Part…

    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
    CenterWell (11/06/25)
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  • Physician Reviewer (Physician Review Unit)

    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
    Blue Cross Blue Shield of Massachusetts (12/10/25)
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