- AMEGO INC (Franklin, MA)
- …of the clients. The Medical Case Coordinator works directly with the Director of Health Care Services in ensuring that all individuals receive appropriate ... of the clients. Work collaboratively with QA and the Director of Health Care Services in auditing...health related topics. Work collaboratively with QA in auditing medical services and overall quality at designated… more
- AMEGO INC (Franklin, MA)
- …is responsible for providing clinical nursing supports and coordination of all medical services for students attending the Amego School Program. The School ... and treatment of students as needed. Assist the Director of Health Care Services and Residential Nurse in coordinating the medical care for all students… more
- Parexel (Providence, RI)
- …Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to ... remo** t **ely in the US or Canada.** The Medical Director is a medical ... aspects of drug development, including all aspects of Medical Monitoring and study design/execution, preferred + Clinical… more
- AMEGO INC (Northborough, MA)
- …responsible for providing clinical nursing supports and coordination of all medical services for individuals attending the Day Habilitation Program and ... supervision to program staff. The Nurse assists the Program Director in the daily operation of the Day Habilitation... clinical nursing supports and coordination of all medical services for individuals attending the Day… more
- Highmark Health (Providence, RI)
- …responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using ... Medical Policy criteria sets to evaluate the ... necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic… more
- Elevance Health (Smithfield, RI)
- …our care management models for our National Account clients. The medical director will be responsible for supporting the clinical vision and implementation ... the health improvement tools offered to clients/ members. The medical director provides clinical expertise...clinical relevance to account reporting regarding use of medical services by members. Involved in identifying… more
- Humana (Providence, RI)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the… more
- Edward M. Kennedy Community Health Center, Inc. (Worcester, MA)
- …projects as assigned by the VP of Behavioral Health Services and/or Medical Director . + Provide clinical supervision to mid-level psychiatric provider(s) ... Worcester MA to provide psychiatric medication evaluation and management service , as well as, consultation to medical ...assigned supervisor. The Psychiatrist is a member of the clinical practice team and works collaboratively with other team… more
- Veterans Affairs, Veterans Health Administration (Framingham, MA)
- …provide oversight of practice management including direct provider supervision, operational issues and clinical performance. The Medical Director will have ... in Boston, Massachusetts in vibrant and diverse clinics. The Medical Director is responsible for ensuring that...> 8000 patients. This full-time position includes approximately 51% clinical time and 49% administrative time. This person will… more
- Advocates (Framingham, MA)
- …ideas and contributions of our staff. The Behavioral Health Regional Medical Director (RMD) is a leadership and clinical role within Advocates' Behavioral ... Health Services Division. The RMD serves as Medical Director for the clinics of an...+ Works with Chief Medical Officer and Clinical Directors to identify regional service and… more
- Advocates (Framingham, MA)
- …to other members of the multidisciplinary teams, including students, if assigned. + Work with Medical Director and Clinical Program Director to develop ... **Overview** *Starting Salary: $255,000* The CBHC Psychiatrist provides team-based, direct clinical services to people served by Advocates' CBHC, including… more
- CVS Health (Providence, RI)
- …it all with heart, each and every day. **Position Summary:** The Executive Director , Business Operations - Clinical Nursing provides strategic leadership and ... direction for the Coram Infusion and Specialty Services nursing organization. This role oversees clinical and operational functions to ensure consistent,… more
- Prime Therapeutics (Providence, RI)
- …our passion and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job ... Description** The Senior Director Clinical Strategy and Oncology Specialty Solutions...the development of strategic business roadmaps that integrate both medical and pharmacy solutions. This position will provide leadership… more
- Cognizant (Providence, RI)
- …submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... denials including but not limited to referral, preauthorization, medical necessity, non-covered services , investigational/experimental and billing resulting… more
- Highmark Health (Providence, RI)
- …anchor, including MAQCs and pharmacists, in collaboration with the partnership director who manages non- clinical workforce activity. + **Relationship Management ... :** **JOB SUMMARY** This role will support the leadership team for Clinical Transformation and executive physicians in leading the day-to-day operational model of… more
- Open Sky Community Services (Worcester, MA)
- …the executive team and medical staff. + Provide direct clinical services , including diagnostic evaluations, medication management, and consultation as ... Director leads the design and implementation of all medical practices within the organization, including clinical ...for the delivery of medical and psychiatric services . They ensure that clinical care meets… more
- Grifols Shared Services North America, Inc (Cranston, RI)
- …(MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy, ... and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions. The...solutions for the therapeutic area(s). + Partners with the Medical Directors, National MSL Sr Director , and… more
- Humana (Providence, RI)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... , requested level of care, and/or requested site of service should be authorized. All work occurs with a...**Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided… more
- State of Massachusetts (Westborough, MA)
- …assigned. Working with fellow Nurse Reviewers, OLTSS program staff, and the OLTSS Senior Medical Director to identify key clinical problems facing OLTSS ... they have the skills necessary to thrive to apply for this role. **Job:** ** Medical Services * **Organization:** **Exec Office Of Health and Human Services *… more
- Humana (Providence, RI)
- …an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... clinical documentation, dispute/grievance and appeals processes, and outpatient services and equipment, within their scope. Medical ...a Lead Medical Director . The Medical Director conducts post- service , inpatient… more
