37 Results for

Adjudicator Jobs in South Boston, MA

Jobs

Senior Pharmacy Operations Specialist Mass General Brigham

Somerville, Massachusetts

$63,648–$92,570.40 / year

The Senior Pharmacy Operations Specialist is a senior-level pharmacy operations professional responsible for ensuring the effective administration, implementation, monitoring, and continuous improvement of the pharmacy benefit for Commercial and Medicaid members. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.

6 days ago

Senior Pharmacy Operations Specialist Brigham and Women's Hospital

Somerville, MA

$63,648–$92,570.40 / year

7 days ago

Manager, Data Quality Care Access

Boston, MA

Remote

$75,000–$95,000 / year

With programs like Future of Medicine , which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers , which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Operational Oversight and Capacity Management: Set daily and weekly priorities across assigned studies and sites, balancing team capacity with participant visits, sponsor timelines, monitoring activity, and database milestones.

3 days ago

Manager, Personnel Background Investigations KPMG International Cooperative

Boston, MA

$127,200–$246,900 / year

Albany, NY; Albuquerque, NM; Anchorage, AK; Ashburn, VA; Atlanta, GA; Austin, TX; Baltimore, MD; Baton Rouge, LA; Bentonville, AR; Birmingham, AL; Boise, ID; Boston, MA; Boulder, CO; Buffalo, NY; Charlotte, NC; Chicago, IL; Cincinnati, OH; Cleveland, OH; Columbus, OH; Dallas, TX; Denver, CO; Des Moines, IA; Detroit, MI; El Segundo, CA; Fort Worth, TX; Ft Lauderdale, FL; Greenville, SC; Harrisburg, PA; Hartford, CT; Honolulu, HI; Houston, TX; Indianapolis, IN; Irvine, CA; Jackson, MS; Jacksonville, FL; Kansas City, MO; Knoxville, TN; Las Vegas, NV; Lincoln, NE; Los Angeles, CA; Louisville, KY; McLean, VA; Melville, NY; Memphis, TN; Miami, FL; Milwaukee, WI; Minneapolis, MN; Montvale, NJ; Morristown, NJ; Nashville, TN; New Orleans, LA; New York, NY; Oklahoma City, OK; Omaha, NE; Orlando, FL; Philadelphia, PA; Phoenix, AZ; Pittsburgh, PA; Portland, OR; Providence, RI; Raleigh, NC; Richmond, VA; Rochester, NY; Sacramento, CA; Salt Lake City, UT; San Antonio, TX; San Diego, CA; San Francisco, CA; San Juan, PR; Santa Clara, CA; Seattle, WA; Shreveport, LA; St Louis, MO; Stamford, CT; Tallahassee, FL; Tampa, FL; Tempe, AZ; Virginia Beach, VA; Washington, DC; Winston-Salem, NC. Responsibilities: Apply comprehensive and specialist knowledge in conducting background investigation case management and adjudication programming to mitigate and minimize risks associated with personnel and third-party talent acquisition or other background related investigations of parties with trusted access to people, information, and assets in alignment to all set forth governmental, client driven, or regulatory obligations.

3 days ago

Personnel Security Specialist Anduril Industries Inc

Quincy, MA

$86,000–$114,000 / year

Handle in-person and virtual requests and inquiries, as it pertains to Security Services Help Requests, Security Information Management System (SIMS), Security Forms, Incoming/Outgoing Visit Request, New Hire Orientation Briefings, Cleared Employee Training, Foreign National Contacts and Foreign Travel Briefings. To ensure your safety and help you navigate your job search with confidence, please keep the following critical points in mind: No Financial Requests: Anduril will never solicit payment or demand personal financial details (such as banking information, credit card numbers, or social security numbers) at any stage of our hiring process.

29 days ago

Regional Sales Manager, Immunology - Nashville, TN Galderma

Boston, Massachusetts

Engage in one-on-one strategic business meetings with Account Managers and HCPs, help to plan and execute sales meetings, conduct routine performance evaluations of Account Managers, and participate in company sponsored meetings. 3+ years in Sales Leadership Role; demonstrated successful history of field force management; Ability to lead and manage direct reports, establishing clear expectations, providing coaching, feedback, and assessing and evaluating performance.

8 days ago

Personnel Security Specialist ANDURIL INDUSTRIES

Quincy, MA

$86,000–$114,000 / year

30+ days ago

Supervisory IT Specialist U.S. Department of Veterans Affairs

Bedford, MA

$125,776–$163,514 / year

SELECTIVE PLACEMENT FACTOR: In addition to the minimum qualifications described above, you must meet the following requirement(s) to be considered qualified for the position: Within the past five (5) years, the applicant has served as the program lead or senior technical authority for a mission-critical, high-availability enterprise system deployed in a cloud environment, built on an enterprise application stack that includes a Java-based application, a relational database, and one of more data replication, synchronization, or messaging mechanisms, with direct ownership of system sustainment data integration or synchronization with a partner organization, and leadership of the technical and/or vendor teams supporting IT. Customer Service - Works with clients and customers (that is, any individuals who use or receive the services or products that your work unit produces, including the general public, individuals who work in the agency, other agencies, or organizations outside the Government) to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations; knows about available products and services; is committed to providing quality products and services.

4 days ago

Vocational Rehabilitation Specialist U.S. Department of Veterans Affairs

Bedford, MA

$69,905–$109,959 / year

Experience that demonstrated knowledge of the vocational rehabilitation problems characteristic of the disabled, including familiarity with available resources and skill in identifying, evaluating, and making effective use of such resources to serve individuals with disabilities; or of the disadvantaged, including knowledge of adjustment problems of the educationally or culturally disadvantaged, familiarity with available adult education and training resources, and ability to recognize problem areas needing special attention. ADDITIONAL SPECIALIZED EXPERIENCE REQUIRED AT THE GS-11 LEVEL INCLUDES: creating individualized assessments to determine level of support necessary for patients; developing employment opportunities through community-based job development; monitoring performance and progress through case reviews; maintaining a database of referral and placement outcomes used to identify aspects of successful program operations and recommended improvements.

4 days ago

Supervisory Contract Specialist (Branch Chief) U.S. Department of Veterans Affairs

Bedford, MA

$125,776–$192,694 / year

Experience with substantial coordinating and integration of a number of major work assignments, projects, or program segments of professional, scientific, technical, or administrative work including but not limited to: coordinating activities among various contracts and negotiations where timing is important, determining projects or program segments to be initiated, dropped or curtailed; restructuring or reformulating goals or objectives based on new information, changes in priorities, changes in directives or legislation that impacts VHA contracting. Waiver: When filling a specific vacant position, the senior procurement executive of the selecting agency, at his or her discretion, may waive any or all of the requirements of Paragraphs A and B above if the senior procurement executive certifies that the applicant possesses significant potential for advancement to levels of greater responsibility and authority, based on demonstrated analytical and decision making capabilities, job performance, and qualifying experience.

5 days ago

Digital Quality & GxP Manager Care Access

Boston, MA

Remote

$110,000–$140,000 / year

With programs like Future of Medicine , which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers , which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. The successful candidate will have hands-on experience implementing GxP compliance at a fast-paced technology company and will support quality for both internal and external software products, systems and AI products.

12 days ago

Temporary Manager, Personnel Background Investigator KPMG International Cooperative

Boston, MA

$127,200–$246,900 / year

Albany, NY; Albuquerque, NM; Anchorage, AK; Ashburn, VA; Atlanta, GA; Austin, TX; Baltimore, MD; Baton Rouge, LA; Bentonville, AR; Birmingham, AL; Boise, ID; Boston, MA; Boulder, CO; Buffalo, NY; Charlotte, NC; Chicago, IL; Cincinnati, OH; Cleveland, OH; Columbus, OH; Dallas, TX; Denver, CO; Des Moines, IA; Detroit, MI; El Segundo, CA; Fort Worth, TX; Ft Lauderdale, FL; Greenville, SC; Harrisburg, PA; Hartford, CT; Honolulu, HI; Houston, TX; Indianapolis, IN; Irvine, CA; Jackson, MS; Jacksonville, FL; Kansas City, MO; Knoxville, TN; Las Vegas, NV; Lincoln, NE; Los Angeles, CA; Louisville, KY; McLean, VA; Melville, NY; Memphis, TN; Miami, FL; Milwaukee, WI; Minneapolis, MN; Montvale, NJ; Morristown, NJ; Nashville, TN; New Orleans, LA; New York, NY; Oklahoma City, OK; Omaha, NE; Orlando, FL; Philadelphia, PA; Phoenix, AZ; Pittsburgh, PA; Portland, OR; Providence, RI; Raleigh, NC; Richmond, VA; Rochester, NY; Sacramento, CA; Salt Lake City, UT; San Antonio, TX; San Diego, CA; San Francisco, CA; San Juan, PR; Santa Clara, CA; Seattle, WA; Shreveport, LA; St Louis, MO; Stamford, CT; Tallahassee, FL; Tampa, FL; Tempe, AZ; Virginia Beach, VA; Washington, DC; Winston-Salem, NC. Exceptional verbal/written communication, collaboration, presentation, and negotiation skills to lead case management and adjudication in an environment driven by customer service, high quality, and teamwork; capable of building strong professional relationships with ability to influence all levels across the organization; able to set and execute strategic initiatives for team; creative thinker with ability to identify innovative business solutions; ability to develop strategic organization and resource plans, defining next generation business and leadership needs.

14 days ago

Regional Sales Manager, Immunology - San Francisco, CA Galderma

Boston, Massachusetts

30+ days ago

Regional Sales Manager, Immunology - Detroit, MI Galderma

Boston, Massachusetts

22 days ago

Pharmacy Claims Adjudication Specialist Onco360

Waltham, Massachusetts

Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.

1 day ago

Berklee Presents Production Assistant Berklee College of Music

Boston, Massachusetts

RESPONSIBILITIES : Support the Berklee Presents production team in performing numerous tasks as needed including distributing production schedules and setlists, set-up and break down rehearsal rooms spaces, print and distribute musical charts, and oversee call times to ensure everything runs smoothly. Hours are varied depending on the assigned project, but you must be consistently available for rehearsals on a Thursday evening during the Fall and Spring semester from 6:00pm-11:00pm, several Friday evenings from 5:00pm/6:00pm-11:00pm, and a few Saturday day rehearsals for full cast run throughs in B41 (150 Mass Ave - multipurpose room).

30+ days ago

Clinical Pharmacist Mail Order Lahey Hospital and Medical Center

Westwood, MA

$123,760–$166,566.40 / year

Age based Competencies: Employees in this job must be competent to provide patient care to the following age groups: Neonatal:Birth to 6 months, Youth: 6 months to 16 years, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -. This position is a part of the interdisciplinary team that includes all pharmacists (i.e., clinical, production, and retail), certified pharmacy technicians, pharmacy interns, technician supervisors, mail, and delivery department managers.

23 days ago

Grievance and Appeals Coordinator (44913) Neighborhood Health Plan of Rhode Island

Smithfield, RI

Under the guidance of the Manager of GAU, collaborates with the designated GAU Reporting Analyst and GAU Manager to generate reports for including but not limited to CMS, EOHHS, OHIC audits, and participates in the compiling of all grievance, appeal, and complaint records selected for on-site audits. Builds effective and successful interdepartmental relationships with all areas of the company and utilizes good communication and customer service skills in responding to internal and external inquiries about the grievance, appeal and complaint process while being able to respond quickly regarding the status.

19 days ago

Principal Supplier Assurance Specialist - Remote RTX Corp

Remote

The Principal Supplier Assurance Specialist is a hands‑on contributor responsible for supporting end‑to‑end ownership of supplier manufacturing output and strengthening supplier performance through structured diagnostics, readiness assessments, and targeted corrective actions. Execute readiness and capability assessments including FAI reviews, PFMEA audits, SPC capability checks, cycle‑time validation, bottleneck analysis, and Run‑at‑Rate support.

11 days ago

IT Specialist U.S. Department of Veterans Affairs

Bedford, MA

$89,508–$116,362 / year

Customer Service - Works with clients and customers (that is, any individuals who use or receive the services or products that your work unit produces, including the general public, individuals who work in the agency, other agencies, or organizations outside the Government) to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations; knows about available products and services; is committed to providing quality products and services. Specialized experience for this position is defined as: diagnosing and resolving complex hardware, software, network, application, and customer-reported incidents; installing, configuring, maintaining, and troubleshooting IT equipment and software applications; AND providing technical guidance and training to customers and lower-graded IT Specialists.

27 days ago

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Adjudicator Jobs in South Boston, MA

Senior Pharmacy Operations Specialist Mass General Brigham

Senior Pharmacy Operations Specialist Brigham and Women's Hospital

Manager, Data Quality Care Access

Manager, Personnel Background Investigations KPMG International Cooperative

Personnel Security Specialist Anduril Industries Inc

Regional Sales Manager, Immunology - Nashville, TN Galderma

Personnel Security Specialist ANDURIL INDUSTRIES

Supervisory IT Specialist U.S. Department of Veterans Affairs

Vocational Rehabilitation Specialist U.S. Department of Veterans Affairs

Supervisory Contract Specialist (Branch Chief) U.S. Department of Veterans Affairs

Digital Quality & GxP Manager Care Access

Temporary Manager, Personnel Background Investigator KPMG International Cooperative

Regional Sales Manager, Immunology - San Francisco, CA Galderma

Regional Sales Manager, Immunology - Detroit, MI Galderma

Pharmacy Claims Adjudication Specialist Onco360

Berklee Presents Production Assistant Berklee College of Music

Clinical Pharmacist Mail Order Lahey Hospital and Medical Center

Grievance and Appeals Coordinator (44913) Neighborhood Health Plan of Rhode Island

Principal Supplier Assurance Specialist - Remote RTX Corp

IT Specialist U.S. Department of Veterans Affairs

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