• US Tech Solutions (Canton, MA)
    …responsible for managing a clinically complex caseload of varied requests for services . The Clinical Reviewer is responsible for making the determination of medical ... lines of business; such as state specific Medicaid and Senior Products (Medicare Advantage and SCO). The Clinical Reviewer...Reviewer functions as a member of the Precert / Outpatient UM team and works under the general direction… more
    Upward (06/26/25)
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  • Senior Clinician

    Veterans Inc. (Worcester, MA)
    …Veterans and their families in New England, is seeking to fill the Senior Clinician for Outpatient Services position and become a valued member of ... Veterans Inc. team! Veterans Inc. is seeking a Senior Clinician to assist in our expanding...Clinician to assist in our expanding continuum of outpatient recovery services in Worcester County. Be… more
    Veterans Inc. (07/13/25)
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  • Clinician Reviewer RN OP Temp

    US Tech Solutions (Canton, MA)
    …responsible for managing a clinically complex caseload of varied requests for services . The Clinical Reviewer is responsible for making the determination of medical ... lines of business; such as state specific Medicaid and Senior Products (Medicare Advantage and SCO).** The Clinical Reviewer...Reviewer functions as a member of the Precert / Outpatient UM team and works under the general direction… more
    US Tech Solutions (06/23/25)
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  • Psychiatric Nurse Practitioner (PMHNP-BC)

    OptiMindHealth (Boston, MA)
    …Work/life balance! Leadership and advancement opportunities! Join a leading clinician -led behavioral health company today! OptiMindHealth (OMH) is expanding and ... psychotherapists to join our team. Today, OMH provides superior behavioral health services patients in Massachusetts and Colorado. Since 2016, we've specialized in… more
    OptiMindHealth (06/24/25)
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  • Physician Liaison / Outreach Coordinator

    OptiMindHealth (Needham, MA)
    …Part-Time FLSA Status: Non-Exempt Location: Needham, MA Join a leading clinician -led behavioral health company today! OptiMindHealth (OMH) is expanding and seeking ... professionals to join our team. Today, OMH provides superior behavioral health services to patients in Massachusetts, Colorado, and Montana. Since 2016, we have… more
    OptiMindHealth (05/08/25)
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  • IPA Coding Associate Director

    CenterWell (Boston, MA)
    …with market operational leaders to identify operational issues that impact clinician and coder performance. + Facilitate meetings with key partners, including ... + MS-DRG auditing or APR auditing experience + Acute in-patient and/or outpatient coding experience + Must be passionate about contributing to an organization… more
    CenterWell (07/24/25)
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  • Director, Physician Leadership - Medical Directors…

    Humana (Boston, MA)
    …this position, you will need to be well versed in CMS knowledge of outpatient , inpatient and appeal criteria including regulation and policies. You much also be ... management processes and be the liaison for the Medicare Market Provider Experience Clinician . This position can be located anywhere within the lower 48 states.… more
    Humana (07/18/25)
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  • Certified Medical Assistant II - GI Clinic

    Tufts Medicine (Boston, MA)
    …Profile Summary** This role focuses on providing medical and clinical support services to patients. In addition, this role focuses performing the following duties: ... be most commonly applied to patient care and/or scientific/laboratory jobs. A senior level role requiring broad knowledge of operational procedures and tools… more
    Tufts Medicine (07/14/25)
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