- Brockton Hospital (Brockton, MA)
- PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management ... Actively solves problems, referring exceptional issues to Vice President. The Director of Case Management is responsible for planning, directing, and… more
- Commonwealth Care Alliance (Boston, MA)
- …staff, including nurse reviewers and support personnel. * Act as liaison with medical director , provider relations, case management and quality teams to ... and organizational determinations. Essential Duties & Responsibilities: The Manager, Utilization Management reports to the Director of Utilization Management… more
- State of Massachusetts (Brockton, MA)
- …Specialist and liaison to the Community Service Agencies. The CYF Supervisor will oversee case management and administrative supervision to assigned CYF Case ... Services Coordinator I(s) to ensure compliance with established standards of care for Case Management . . Maintains caseload oversight for assigned Human Services… more
- The Salvation Army (Canton, MA)
- …implementation of the program's objectives including training of Corps staff involved in Case Management , collection of data, and reporting on outcomes. The ... and weekends, will be required occasionally. Duties and Responsibilities Supervision of Case Management /Social Services within the Clusters + Provide ongoing… more
- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- State of Massachusetts (Boston, MA)
- … management of the CORI check and Warrant check processes. In addition to management of these functions, the Director serves as a primary subject matter ... AND RESPONSIBILITIES (NOT ALL INCLUSIVE):_* *__* *_1) Leadership and Oversight_* . The Director provides oversight and management of the core activities of the… more
- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... Case managers or Care managers on complex case management , including familiarity with social determinants...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- State of Massachusetts (Boston, MA)
- …and best practices; * Proficiency in relevant software and legal technology, including case management systems and data analysis tools. * Ability to handle ... INTO YOUR BROWSER IF THE EMBEDDED LINK DOES NOT WORK):*https://careers-publiccounsel.icims.com/jobs/2955/managing- director operations/job The Committee for Public Counsel Services, the… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …health care, from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations ... Union Name: None Patient Facing: Yes The Associate Medical Director of Medical Respite, in close collaboration with the...5 years of clinical experience as an NP/PA required. Management experience is strongly preferred. DEA X-waiver required. +… more
- Datavant (Boston, MA)
- …experiences to realize our bold vision for healthcare. **Role Summary:** The ** Director of Internal Audit** will design, implement, and oversee Datavant's legal and ... audit standards. Reporting to the Chief Compliance and Privacy Officer, the Director of Internal Audit will evaluate the effectiveness of internal controls, risk… more
- Humana (Boston, MA)
- …experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by members of ... the Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those… more
- Humana (Boston, MA)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Commonwealth Care Alliance (Boston, MA)
- …with responsibility for managing the effective utilization of healthcare services, case / disease management , program development/ management /evaluation and ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term services and… more
- State of Massachusetts (Boston, MA)
- …benefits programs, including eligibility criteria and intake procedures, eligibility regulations, case management systems, and controls for fraud prevention and ... 16V for more information about BPI's statutory mission. *BPI Director : Position Overview* The OIG is looking for a...detection. * At least ten years of management experience as a team leader or supervisor. *… more
- Sumitomo Pharma (Boston, MA)
- …Bachelor's or master's degree in business, scientific or related field (experience in case management a plus) + Demonstrated experience developing and managing ... highly motivated, and experienced individual for the position of ** Director , Patient & HUB Operations, Rare Disease** . The...ability to create process maps and flows. + Project management skills including the ability to break down initiatives… more
- Evolent (Boston, MA)
- …meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use ... Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a requested… more
- Datavant (Boston, MA)
- …experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the ... combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be accountable for ensuring our products deliver… more
- CVS Health (Boston, MA)
- …it all with heart, each and every day. **Position Summary** + The Sales Director (ie Sr. Analyst, Sales Executive - internal title) will have an assigned territory ... in excess of assigned target. + Additionally, the Sales Director will support key activity related to prospecting and...will support key activity related to prospecting and RFP management across all territories. + This role will report… more
- Datavant (Boston, MA)
- …**You Will:** + Reporting to the Head of Commercial GTM, the Director , Sales Enablement will develop client-facing messaging, design sales training programs, and ... and analyze full-funnel metrics to find insights and assist management in making sound decisions + Set up &...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more