• Medical Director - Claims

    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
    Humana (11/01/25)
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  • PCO Medical Director - UM - Full…

    CenterWell (Boston, MA)
    …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
    CenterWell (11/06/25)
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  • Medical Director - Medicaid N.…

    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 ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (10/25/25)
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  • Medical Director - Nat'l UM IP (4x10…

    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 (11/07/25)
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  • Business Development Director - Casualty…

    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
    Sedgwick (09/11/25)
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  • Medicare/Medicaid Claims Editing Specialist

    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
    Commonwealth Care Alliance (08/26/25)
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  • Director , Utilization Management BH

    Commonwealth Care Alliance (Boston, MA)
    …of utilization management functions with network strategy, vendor relationship management and claims processing. Works closely with provider relations on ... 013650 CCA-Auth & Utilization Mgmt * Directs, coordinates and evaluates efficiency and...Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
    Commonwealth Care Alliance (10/02/25)
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  • Director , Strategic Planning & Operations…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    …the asset lifecycle. This role reports directly into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities ... The Director , Strategic Planning & Operations is a pivotal...multi-year strategic roadmaps tailored to each therapeutic area **Budget Management ** + Oversee budgets for global medical more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • GYN Oncology, Regional Medical Scientific…

    Merck (Boston, MA)
    **Job Description** The Oncology Regional Medical Scientific Director , Oncology is a credentialed (ie, MD, PhD, PharmD, or DNP) therapeutic and disease expert ... about any drug, vaccine or biologic product. The Oncology Regional Medical Scientific Director provide to Scientific Leaders balanced, factual, scientific… more
    Merck (11/07/25)
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  • Senior Director , Medical Mature…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    **Job Summary** The Senior Director , Mature Assets Lead within the CNS medical business unit (BU) is a critical role responsible for shaping the strategic ... to balance competing priorities. This position reports directly to the Executive Director , CNS Medical BU Lead. **Job Description** **Key Responsibilities… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Associate Director , Congress…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    The Associate Director , Congress and Medical Education Strategy & Execution is responsible for executing and contributing to the global medical strategy and ... through deep scientific understanding and collaborative partnerships. The Associate Director partners closely with global and regional cross-functional stakeholders… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Senior Director , Medical Affairs…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    The Senior Director , Medical Affairs Solutions & Analytics provides oversight and spearheads Global Medical Affairs (GMA) business enablement and analytic ... efficient Medical Affairs operations as needed, including Medical customer relationship management , insights management...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Director , Provider Relations

    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
    Commonwealth Care Alliance (10/18/25)
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  • Medical Director , Medicare…

    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
    Humana (11/06/25)
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  • Associate Director , Scientific…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    …consistency, and compliance. This position reports directly to the Senior Director , CNS Medical Communications Lead. **Job Description** **Key Responsibilities ... plan for the relevant therapeutic area portfolio, in partnership with the Senior Director , Medical Communications Lead, CNS Lead, and cross-functional teams (eg,… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Director , Strategic Supply Chain…

    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
    Celestica (10/03/25)
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  • Associate Director , Commercial Data…

    Sumitomo Pharma (Boston, MA)
    …a dynamic, highly motivated, and experienced individual for the position of **Associate Director , Commercial Data Management ** . This high impact role requires a ... technically skilled person to support our growing Commercial Data Management (CDM) function, serving as a key liaison between...(Salesforce, Veeva), syndicated data (IQVIA & Symphony sales and claims data, MMIT) The base salary range for this… more
    Sumitomo Pharma (10/30/25)
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  • Human Resources Director (View Boston)

    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
    ASM Global (09/18/25)
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  • Associate Director , Strategic Planning…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    The Associate Director , Strategic Planning & Operations will support the assets of varying lifecycle stages in the relevant therapeutic area portfolio. This role is ... in driving operational excellence and innovation within our Global Medical Affairs organization, with a specific focus on the...are in place. This position reports directly into the Director , Strategic Planning Lead, who in turn reports into… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Associate Director , Federal Government…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    **Job Summary** **Job Description** The Associate Director (AD), Federal Government Affairs, will assist in the development, communication, and deployment of ... Health, Nephrology, Immunology, and Rare Disease. This role reports directly to the Director , Federal Government Affairs and located in the Washington, DC area. The… more
    Otsuka America Pharmaceutical Inc. (11/06/25)
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