11 medical reviewer jobs found in Boston

Become a part of our caring community The Utilization Management Behavioral Health Professional uses behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Behavioral Health Professional uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas....

Job Description: Vertex is seeking a Associate Director to join the Patient Support Operations & Vendor Management Team within the US Patient Support Center of Excellence. This team supports Vertex North America Commercial’s Patient Support organizations, which assist patients living with Cystic Fibrosis, Sickle Cell Disease, Beta-thalassemia, and Acute Pain. The Patient Support Operations & Vendor Management Team oversees patient support vendors, including those managing financial assistance programs, benefits investigations, prior authorizations, and travel programs. The team also collaborates with Specialty Pharmacy partners to ensure a seamless patient experience. The Associate Director, Vendor Management is responsible for leading the strategy, oversight, and performance management of vendors supporting patient support programs. This role ensures external partners deliver high-quality services aligned with program goals, compliance requirements, patient...

The Department of Mental Health (DMH) is seeking an organized and dynamic individual for the position of Human Services Coordinator II to join The Massachusetts Mental Health Center (MMHC) team. The Human Service Coordinator II orients, trains, and provides direct supervision to Human Service Coordinator (HSC) I staff and assigns individuals referred for case management to HSC I staff ensuring the provision of appropriate, quality care while monitoring treatment and rehabilitation progress. This role provides oversight of case management services to ensure compliance with DMH Regulations, policies, and procedures and functions as liaison to DMH inpatient facilities, community hospitals, and service providers while promoting DMH’s philosophy of recovery, trauma informed care, person centered choices and cultural humility. Duties and Responsibilities: (These duties are a general Summary and not all inclusive): Oversight and Compliance: Provide supervision and...

Case Management Nurse Transition Residency Program 48928 1 Boston Medical Center Place, Boston, Massachusetts Full Time POSITION SUMMARY: The Care Management Department is offering experienced nurses an exciting opportunity to transition into the specialized field of care management. As a dynamic and diverse team, we provide comprehensive care to patients across the BMC continuum. We seek dedicated nurses who are passionate about serving our unique patient population and motivated by opportunities for professional growth. Ideal candidates have experience in quality improvement initiatives or active participation in unit-based or hospital-wide councils. We also value multilingual proficiency and a commitment to lifelong learning, including engagement in conferences, volunteer work, or other professional development activities. Our Nurse Residency Transition Program is designed to equip experienced nurses with the...

Position Description & Qualifications The Army PPB BOS program is seeking a CM Specialist to deliver cloud-based configuration management, DevSecOps, and release engineering activities to support the enterprise systems. Serco supports the US Army as the prime for PPB BBOS and consists of multiple managed cloud environments and numerous hosted data, applications, and processes that enable Army Planning, Programming and Budgeting (PPB) processes to develop the Army Future Years Defense Program (FYDP). Our team performs administration, maintenance, and improvement of IT systems that collect POM, Budget Estimate Submission (BES) and President's Budget resources data deemed necessary to accomplish the Department's mission. In this role, you will: Support applications and systems operating within AWS GovCloud and Commercial Cloud environments/ Be responsible for developing, maintaining, and enforcing software configuration management tools and processes that...

Job Description Staff Program Manager, Incident Management - Autonomous Vehicle Development At General Motors, our product teams are redefining mobility. Through a human-centered design process, we create vehicles and experiences that are designed not just to be seen, but to be felt. We're turning today's impossible into tomorrow's standard - from breakthrough hardware and battery systems to intuitive design, intelligent software, and next-generation safety and entertainment features. Every day, our products move millions of people as we aim to make driving safer, smarter, and more connected, shaping the future of transportation on a global scale. The Safety Assurance for Effective Autonomous Driving Software (SAFE-ADS) department is part of GM's Global Product Safety, System, and Certification (GPSSC) organization. Our mission is to help GM deliver trusted automated driving products. As the central authority for automated driving system (ADS) safety, SAFE-ADS brings...

About Jerry.ai Jerry.ai is building America’s first and only AI-powered super app to radically simplify car ownership. We are redefining how people manage owning a car, one of their most expensive and time-consuming assets. We are the #1 rated and most downloaded app in our category with a 4.7 star rating in the App Store. We have more than 5 million users, and have helped millions find better auto insurance — and we’re just getting started. About The Opportunity: We're looking for a sharp, structured, product management thinker to join our Growth team. This role is purpose-built for someone who has built strong problem-solving and analytical foundations — whether through consulting, strategy, or early product work — and is ready to apply those skills to real product ownership in a fast-moving, high-stakes environment. You'll be embedded in one of the most important teams at Jerry, working on the funnels that directly drive how millions of users discover,...

Hiring Transparency: Official Communication: All job offers and communication regarding them will arrive from email addresses ending in @innovateteam.com . Secure Information: We prioritize your data safety. We never request bank information via email or text. Instead, we follow a secure process through our dedicated payroll system. Remember: If your communication differs from this process, it's not from Innovate. Onsite Service Management Lead / Point of Contact Location: Boston, MA, Position: Onsite Service Management Lead / Point of Contact Reports To: FLSA: Exempt Location: Boston, MA, Posted: 4/29/26 Job Description Embrace the opportunity to join Innovate! Inc. and become a valued member of our team. We are seeking driven individuals who are passionate about leveraging technology to tackle environmental challenges and drive positive change. If you thrive in a collaborative, fast-paced...

Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) . Job Description : Summary The Asset Management Business Partner will be directly responsible for the life–cycle performance of all assets in the Business Unit (BU) that they support. S/he is responsible for fleet management, product line analysis, margin performance, customer and location profitability and vehicle performance analysis. The incumbent is also responsible for managing the ROA on 188,000 plus vehicles or $6.8 Billion in assets across the entire company. Additionally, the Asset Manager will ensure that all asset processes are coordinated across all functional area's in the BU including sales, rental, maintenance, SCS, RVS, financial aspects of the fleet and leadership to all functional areas that they touch. S/he will report directly to the Director of Asset Management. Essential Functions Responsible for: Fleet Management, Product...

Job Summary In collaboration with the Senior Director of Clinical Management, the Director is responsible for the operational strategy and management of Otsuka clinical programs, including coordination with other relevant parties (e.g., other Otsuka departments, external service providers (ESPs), etc.). Responsibilities include the planning, execution, and completion of clinical programs according to applicable regulations and guidance; ICH Guidelines, Good Clinical Practices (GCP), and Otsuka SOPs, within agreed upon timelines and budget. Job Description Provides scientific clinical research and operational expertise in the development of overall strategy and objectives of the Global Clinical Development Plan (GCDP), including performing/overseeing and providing background research. May represent Clinical Management in the development of the Clinical Development Plan, timelines, and budget for Business Development opportunities. Ensures program specific...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title AVP, Enterprise Program Portfolio Management - REMOTE Job Description The AVP Program Portfolio Management is responsible for leading and developing the overall portfolio and project vision for one or more accounts. This position will be responsible for creating an implementation strategy to accomplish the division's long term strategic and market driven vision within their accounts. This position requires broad technical and analytical experience, as well as strong interpersonal leadership skills. This leader works directly with external clients and customers to ensure that business needs are met while leveraging cross functional internal, matrixed resources to deliver results. Responsibilities Lead a long-term...