- Humana (Boston, MA)
- …a part of our caring community and help us 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Beth Israel Lahey Health (Burlington, MA)
- …1 Transplant Administrators meetings. **Strategic** 1. In conjunction with the Chairs, Medical Directors and Executive Director , is responsible for business ... and Managers in establishing department policies and procedures. 3. Works with Chairs, Medical Directors, Executive Director and Managers on the development of… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake Administrator is responsible for triaging and assigning all incoming… more
- Point32Health (Canton, MA)
- …and trend to aid in managing pharmacy costs. + Collaborate with the Pharmacy Medical Director and Marketing to develop member and provider specific communication ... (P&T) Committee and Drug Coverage Committee (DCC), participates in medical policy formulation and interpretation, and provides information/training to new… more
- Tufts Medicine (Boston, MA)
- …clinical trial budgets with sponsors and assists with the completion of Medicare Coverage Analyses. 4. Keeps abreast of new and modified sponsor regulations ... of fiscal state of research program/laboratories and makes recommendations to PIs and director for planning purposes. 9. Meets regularly with director and PIs… more