- Merck & Co. (Boston, MA)
- …are seeking a highly skilled and motivated Associate Principal Scientist/Associate Director with expertise in conducting outcome researching using real world data, ... patient level healthcare data, including but not limited to administrative claims , EHR/EMR, disease registry, and public-use databases. Develop machine learning… more
- Eisai, Inc (Boston, MA)
- …internal cross functional partners including but not limited to Associate Director Regional Marketing, Oncology Field Reimbursement Managers, and other specialty ... (eg, PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state… more
- Lincoln Financial (Boston, MA)
- …#:** 74680 **The Role at a Glance** We are excited to bring on a highly motivated Claims Director to our Claims Organization! * As a Claims ... manage will oversee and ensure the fair, ethical and timely management of complex claims for your assigned area(s) of responsibility. You will also be directing and… more
- Citizens (Westwood, MA)
- …career with exciting new challenges and opportunities to stretch yourself. As the Director of First Line Risk, you will represent the first line of defense ... of Risk Managers and/or Senior Risk Managers primarily supporting the Fraud and Claims line of business Qualifications: + 8-12+ years experience in Risk Management,… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. Analyst plays ... of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the… more
- Humana (Boston, MA)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Boston, MA)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Boston, MA)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Commonwealth Care Alliance (Boston, MA)
- …for One Year Term **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Position Summary: Reporting to the Director , Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. Specialist II is ... Medicaid) and CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance team and works closely with Cognizant (TPA)… more
- Beth Israel Lahey Health (Boston, MA)
- …a job, you're making a difference in people's lives.** Reporting to the Director of Revenue Cycle Operations, this position is responsible for planning, coordinating ... and managing HIPAA EDI activities including Claims , Remittance, as well as Provider Enrollment processing for Harvard Medical Faculty Physician's (HMFP) professional… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …nutraceutical products for the maintenance of everyday health We are seeking a Director , Global Clinical Development (GCD) who will be responsible for the design and ... a global health-care market. The duties assigned to the Director , Global Clinical Development include the following: + Consult...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- **Job Description** Otsuka is seeking a Director , Global Clinical Development (GCD), who will be responsible for the design and oversight of clinical research ... global health-care market. The specific duties assigned to the Director , Global Clinical Development include the following: + Consults...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible for certain assets ... the broader overall TA strategy determined by the Sr. Director , Franchise Lead CNS Early Assets. **Position Summary:** The...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- **Associate Director , Channel Strategy and Patient Affordability** The Associate Director , Channel Strategy and Patient Affordability reports to the Executive ... Director , Channel Strategy and Patient Affordability. The Associate ...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …transform the health experience, one connection at a time, together. The ** Director , Digital Health Corporate Counsel** will be responsible for providing legal ... their business. The position will report to the Executive Director , Deputy General Counsel. The Director will...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- The Associate Director , Brand and Sales Analytics will be part of a high performing team that provides actionable, innovative solutions to address key business ... questions & opportunities. The Associate Director , Sales & Marketing Analytics should be able to...IQVIA, Symphony, Market Access Data (ie patient longitudinal data, claims data, distribution, sales, demand, promotion, formulary) + Strength… more
- CVS Health (Boston, MA)
- …**This role is responsible for ensuring the accuracy and compliance of medical claims , which involves applying various editing rules and guidelines to ensure proper ... coding and payment. The lead director manages a team of claim editors, develops and...and delivery of new edits + Ensure that medical claims are reviewed and edited according to established guidelines… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …Specialty Pharmacy operations for OAPI The position will report to the Executive Director , Channel Strategy and Patient Affordability We are seeking a highly skilled ... and motivated Director of Specialty Pharmacy Operations to lead and oversee...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- 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 ... member of the Government Affairs Leadership Team, the Senior Director of the Federal Government Affairs will play an...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
