- 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
- Sedgwick (Boston, MA)
- …a plus, not required. **Experience:** Ten (10) years of relationship building in the claims management or risk management area or equivalent combination of ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (Northeast Region) As a Business Development… more
- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for...and Analytics + Direct and relevant experience with HCFA/UB-04 claims management , coding rules and guidelines, and… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
- Humana (Boston, MA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Boston, MA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Commonwealth Care Alliance (Boston, MA)
- …provider engagement, delegation partnerships, provider services, contracting, quality, compliance, medical management , and analytics teams to advance provider ... contracting, or network operations, including 3-5 years in a director or senior management role. * Experience...Familiarity with CRM systems (eg, Salesforce) and provider relationship management tools. * Understanding of claims operations,… more
- Humana (Boston, MA)
- …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Sedgwick (Boston, MA)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports ... service requirements and assure efficient, cost effective, quality program delivery for medical and disability management . + Coordinating and evaluating the… more
- Humana (Boston, MA)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- CVS Health (Boston, MA)
- …supports over 6 million members on its core administrative platforms. The Lead Director , Technology Product Management for our Medicare Enrollment & Billing will ... security, etc. to ensure overall cohesion for the Medicare claims platform. You will lead a team of product... platform. You will lead a team of product management colleagues, creating a positive team culture through development… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …us transform healthcare? Bring your true colors to blue. What we need The Associate Director of Clinical Data Management will be a key leader in executing ... successful candidate will be responsible for leading the clinical data management function, providing strategic direction, and ensuring the delivery of high-quality,… more
- Celestica (Boston, MA)
- Req ID: 129127 Remote Position: Hybrid Region: Americas Country: USA **Summary** The Director , Strategic Supply Chain Management is a global supply chain focal ... provides guidance to ensure capacity is installed as needed. + Supports E&O claims , shortage management and follow up escalations with customers for resolutions.… more
- ASM Global (Boston, MA)
- POSITION: Human Resources Director DEPARTMENT: Human Resources REPORTS TO: General Manager FLSA STATUS: Salaried/Exempt LEGENDS GLOBAL Legends Global is the premier ... & consulting, owner's representation, sales, partnerships, hospitality, merchandise, venue management , and content & booking of world-class live events and… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- **Position Summary:** The Director GVE Operations oversee and coordinates projects within the department to ensure alignment with organizational goals. This role is ... other integrated data generation initiatives. This position reports to the Senior Director , Global Integrated Evidence & Innovation Operations and can be based in… more
- Ophthalmic Consultants of Boston (Waltham, MA)
- …scope of operations, including: + Front Desk, Credentialing, Billing, and Claims Management + Ensuring accuracy and timeliness of medical claims , ... Join a Leader in Eye Care: Director of Revenue Cycle & Billing at Ophthalmic...collaborative environment where your expertise in healthcare revenue cycle management can make a meaningful impact on both patient… more
- Commonwealth Care Alliance (Boston, MA)
- …of utilization management functions with network strategy, vendor relationship management and claims processing. Works closely with provider relations on ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term services and… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- **Associate Director , Field Strategy, Nephrology/Immunology** **Position overview:** The **Associate Director , Field Strategy** plays a critical role in enabling ... execution and provide feedback to optimize performance at all levels + **Compliance Management :** + Must comply with all state and federal laws, regulations and… more