- Commonwealth Care Alliance (Boston, MA)
- …and performance monitoring and + Leads the Utilization Management team in managing and continuously improving UM program design, policies, procedures, workflows, ... **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all...of Utilization Management leads and manages all utilization management ( UM ) functions for physical health services and long term… more
- 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