• Medical Director -- Claims

    Humana (Boston, MA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 (05/08/25)
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  • Healthcare Medical Claims Coding Sr.…

    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 (03/04/25)
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  • Global Medical Director , Evidence…

    Sanofi Group (Cambridge, MA)
    **Job title** : Global Medical Director , Evidence Generation - Insights and Strategy **Location:** Cambridge, MA, Morristown, NJ **About the Job** Sanofi's ... Evidence Generation Lead of the Next-Gen Immunology Franchise, the Medical Director will also be responsible for...expertise in developing RWE studies, as well as study management and publications. + Prior experience in claims more
    Sanofi Group (05/02/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Care Plus…

    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 (04/24/25)
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  • Medical Director - National Medicare…

    Humana (Boston, MA)
    management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
    Humana (05/07/25)
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  • Director , Medical Affairs Congress…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    ** Director , Medical Affairs Congress Strategy and Execution** The Director , Medical Affairs Congress Strategy and Execution, plays a pivotal role in ... and elevate our overall GMA objectives. **Position Overview** Reporting to the Senior Director of Medical Affairs Excellence & Operations, this role will… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Global Medical Director , Evidence…

    Sanofi Group (Cambridge, MA)
    **Job title** : Global Medical Director , Evidence Generation - Innovation & Partnerships **Location:** Cambridge, MA, Morristown, NJ **About the Job** Sanofi's ... Medical Evidence Generation Lead of the Next-Gen Immunology Franchise, the Medical Director will also be responsible for offering strategic insights and… more
    Sanofi Group (04/23/25)
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  • Medical Director - Florida

    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 (04/24/25)
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  • Associate Director , Global Medical

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    **Position Overview** Otsuka is seeking an exceptional Associate Director of Global Medical Affairs (GMA) Excellence & Operations to support our emerging rare ... optimize systems and tools to enhance productivity and data management within Global Medical Affairs + Develop...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Director , Global Medical

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    The Director , Global Medical Publications will support Otsuka in leading and developing an overall scientific communication strategy for publications and ... congresses, and will work closely with the Global Medical Affairs Teams, Clinical Teams, Global Value & Real-World Evidence Teams, and Publications Management more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Medicare…

    Humana (Boston, MA)
    …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (04/24/25)
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  • Director , Global Clinical Development

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Experience with the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    …personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and ... disciplines, including immunology, biostatistics, clinical pharmacology, formulation science, data management , and medical writing. + Complete understanding of… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Deputy Director , Safety Net Programs

    State of Massachusetts (Quincy, MA)
    …process improvement initiatives. In addition, the Deputy Director will assist the Director with the day-day management of the HSN Operations unit which ... the Executive Office of Health and Human Service. The Director of Safety Net Programs oversees the Health Safety...unit which includes overseeing Safety Net help desk, manual claims payments, Medical Hardship application and payments,… more
    State of Massachusetts (04/16/25)
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  • Corporate Medical Director

    Humana (Boston, MA)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (04/24/25)
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  • Sr Director , Performance Suite Analytics

    Evolent (Boston, MA)
    …health outcomes and a more connected care journey. We are hiring for a Senior Director to join our Finance Team. The candidate selected for this role will be part ... and its customers in the Performance Suite where Evolent does not pay claims + Establish ideal data transfer protocols during client onboarding and implementation,… more
    Evolent (05/02/25)
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  • Senior Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Senior Director , Federal Government…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    We are seeking a Senior Director , Federal Government Affairs to lead our US federal government engagement in Washington, DC. This position reports to the Vice ... leader, and a member of the Government Affairs Leadership Team, the Senior Director of the Federal Government Affairs will play an integral role in developing… more
    Otsuka America Pharmaceutical Inc. (04/19/25)
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  • Associate Director , Statistical…

    Otsuka America Pharmaceutical Inc. (Boston, MA)
    …innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health** **As ... the** **Associate Director ,** **Statistical** **Programming** **, you will** **be** **responsible for** **managing** **various programming activities throughout all… more
    Otsuka America Pharmaceutical Inc. (05/02/25)
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