- CVS Health (Boston, MA)
- …with a strong background in the PBM industry to join our team as the Lead Director , Financial Change Order Connected Ecosystem. In this role, you will lead a team of ... adjustment process to capture client-initiated plan design, formulary and/or UM changes that could impact our ability to meet...in finance, Business Administration, Data Science, or a related field . **Pay Range** The typical pay range for this… more
- Commonwealth Care Alliance (Boston, MA)
- …with all regulatory, contract and NCQA requirements. + Together with the Director of UM and Sr. Medical Director of medical policy, manage the ... The Manager, Medical Policy reports to the Director of UM , and manages the personnel...accredited college or university, in nursing or a health-related field preferred **Desired Education:** + Masters in Public Health,… more
- Fallon Health (Worcester, MA)
- …met and medical necessity determination needs to be made by the Medical Director Independently performs research to ensure resolution of identified concern ... any type of authorization related questions and or issues, assisting Durable Medical Equipment (DME) vendors with invoice processing, working with Fallon Health … more