• Clinical Review Clinician

    Actalent (Boston, MA)
    Clinical Review Clinician Job Description As a Clinical Review Clinician specializing in appeals , you will be responsible for preparing case ... to appeals requests. + Partner with interdepartmental teams to improve clinical appeals processes and procedures, preventing recurrences based on industry… more
    Actalent (07/12/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …utilization review , ideally experience with public programming, and excellent clinical judgment. They will work well both independently and in conjunction with ... & Responsibilities:** + Primary responsibility for performing daily medical reviews, appeals as appropriate, correspondence regarding review determinations and… more
    Commonwealth Care Alliance (06/27/25)
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