• Senior Medical Director , UM

    Elevance Health (Woburn, MA)
    … Benefits Management Clinical Operations team is looking to hire a **Senior Medical Director ** to manage a team of physicians performing clinical coverage ... for our Musculoskeletal (MSK) Solution. (internal title: Manager Clinical Operations Medical Director ) Responsible for providing day-to-day guidance, support,… more
    Elevance Health (05/14/24)
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  • Senior Medicare Clinical Compliance Consultant

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …senior leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... and scope projects; keep project leads, senior consultants, and Director informed of key issues/ risks and meet deadlines...of key issues/ risks and meet deadlines by tightly managing deliverables, coordinating input from leaders, and ensuring all… more
    Blue Cross Blue Shield of Massachusetts (03/02/24)
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  • Senior Pharmacist

    Highmark Health (Boston, MA)
    …in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, ... and consult with the Organization's Associate Medical Directors and Medical Directors when appropriate,...and Targeted Medication Reviews. + Identify and assist in managing department process improvements to maximize overall efficiencies. +… more
    Highmark Health (04/04/24)
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