• Director of Utilization

    Insight Global (Boston, MA)
    Job Description Insight Global is sourcing for a Utilization Management Director to join a not-for-profit community based healthcare organization within the ... federal, state, and local regulatory guidelines. -Support the development of utilization management policy initiatives. -Support the development and… more
    Insight Global (07/12/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager, Utilization Management reports to the Director of ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
    Commonwealth Care Alliance (05/21/25)
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  • Medical Director - Gulf South

    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 in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/08/25)
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  • Medical Director - South Central

    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 in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/11/25)
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  • Medical Director - Mid West Region

    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 in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    … will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... other medical management team members. + Support the development of utilization management policy initiatives. + Support the development and implementation… more
    Commonwealth Care Alliance (06/27/25)
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  • Manager Utilization Management

    Beth Israel Lahey Health (Burlington, MA)
    …taking a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for ... compliance reviews as needed. + Continuously monitors regulatory requirements for Utilization Management . + Attends Mandatory Education programs required by… more
    Beth Israel Lahey Health (06/06/25)
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  • Medical Director , MSK Surgery

    Evolent (Boston, MA)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
    Evolent (05/20/25)
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  • Field Medical Director , Interventional…

    Evolent (Boston, MA)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (04/30/25)
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  • Director , Physician Leadership - Medical…

    Humana (Boston, MA)
    …The Director , Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director ... role, you will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus… more
    Humana (07/18/25)
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  • PV Risk Management Scientist/Associate…

    Takeda Pharmaceuticals (Boston, MA)
    …inspire you and empower you to shine? Join us as a PV Risk Management Scientist/Associate Director . At Takeda, we are transforming the pharmaceutical industry ... for excellence in everything we do. As an Associate Director / PV Risk Management Scientist, being part...controlled access program + Provide guidance regarding tracking risk management commitments including utilization of a tracking… more
    Takeda Pharmaceuticals (05/22/25)
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  • Field Medical Director , MSK (Spine)…

    Evolent (Boston, MA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a specialty match...cases. you will be a key member of the utilization management team. We can offer you… more
    Evolent (07/02/25)
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  • Field Medical Director , Cardiology

    Evolent (Boston, MA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
    Evolent (07/02/25)
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  • Regional Field Director , RNS Program…

    United Therapeutics (Boston, MA)
    …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
    United Therapeutics (06/05/25)
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  • Executive Director , Operations…

    CBRE (Boston, MA)
    Executive Director , Operations Management - OnDemand & Variable Tech Job ID 220744 Posted 11-Jul-2025 Service line GWS Segment Role type Full-time Areas of ... Interest Facilities Management Location(s) Remote - US - Remote - US...technicians and 3P service providers, ensuring optimal route planning, utilization , and service quality across all geographic regions. +… more
    CBRE (07/15/25)
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  • Capacity & Resource Management

    Grant Thornton (Boston, MA)
    …to share strategy, to implement process improvements and to roll out capacity management strategies to maximize utilization and drive operational excellence + ... Grant Thornton is seeking an Advisory Capacity & Resource Management (C&RM) Leader to join the team. Approved office...on yearly budget planning for headcount, gross charge hours, utilization , and leverage. You will lead your team to… more
    Grant Thornton (05/09/25)
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  • Director , Health Services--Northeast…

    Humana (Boston, MA)
    …provider population health programs focused on Stars, HEDIS, MRA, chronic condition management , and other efforts to reduce avoidable utilization * Supporting ... community and help us put health first** The Clinical Director is a key member of the regional clinical...performance, and coordinating with cross-functional teams to drive quality, utilization , and cost-of-care outcomes. At the core, this is… more
    Humana (07/18/25)
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  • Director of Infrastructure and Client…

    State of Massachusetts (Haverhill, MA)
    …with the goal of student success. * Job Description:* *POSITION: Full-Time Director of Infrastructure and Client Services ( Director ): *IT Client Computing; ... hours and weekend hours as needed; Non-Unit Professional Position *SUMMARY: *The Director of Infrastructure and Client Services is an in-person position and… more
    State of Massachusetts (05/30/25)
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  • Field Medical Director , MSK Surgery

    Evolent (Boston, MA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization management team. We can offer you a… more
    Evolent (07/04/25)
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  • Field Medical Director , Oncology

    Evolent (Boston, MA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management team. We can offer you a… more
    Evolent (05/20/25)
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