Medical Program Auditor/ Analyst University of Massachusetts Medical SchoolMedical Program Auditor/ AnalystWestborough, Massachusetts4-6 years of related experience in the healthcare industry, business, with at least two years of experience conducting data mining in the healthcare insurance industry, healthcare claim audits, administrative medical record reviews or other claims analysis related experience. Overview: Under the general direction of the Associate Director or designee, the Fraud, Waste, and Abuse (FWA) Auditor serves a crucial role in identifying, investigating, and preventing fraud, waste and abuse for Medicaid programs.
NewOutpatient Coder II UMass Memorial Health Care IncOutpatient Coder IIWorcester, MA$23.81–$35.08 / hourAdheres to the coding and billing regulations established by the American Hospital Association (AHA), American Medical Association (AMA), and Centers for Medicare and Medicaid Services (CMS). Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve.
Senior Director, Field Reimbursement AlexionSenior Director, Field ReimbursementBoston, MassachusettsProven experience creating and managing compliant field-based reimbursement and access teams, including key account targets, size, structure, strategy, programs/initiatives, compliance requirements (PHI), KPIs, analytics, integration with patient support services. Superb knowledge of government and commercial payers for specialty products (rare disease) across buy & bill and specialty pharmacy pathways, prior authorization and appeal requirements, coding, appropriate claim submission, and integration with patient assistance programs.
Senior Software Engineer, Billing Workflows - Athenacollector Athenahealth inc.Senior Software Engineer, Billing Workflows - AthenacollectorBoston, MA$119,000–$203,000 / yearWe offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients - powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Use AI coding assistants and agentic tools (e.g., Claude Code, Codex or similar) throughout the SDLC for scaffolding, code generation, test authoring, and first-pass code review while retaining full ownership of correctness, security, and maintainability of everything that ships.
NewMedical Director - Spine CVS Health CorpMedical Director - SpineMA$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities. Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer based applications.
Medical Director - ENT CVS Health CorpMedical Director - ENTMA$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Senior Clinical Research Director SanofiSenior Clinical Research DirectorCambridge, MA$236,250–$393,750 / yearCollaborates with other CRDs within the project, ensures leadership, builds consensus, coordinates action plans with stakeholders to resolve project-related study issues, anticipates potential issues (sharing lessons learned) across the project or study teams. Collaborate with other CRDs within the project, ensure leadership, buildsconsensus, coordinate action plans with stakeholders to resolve project-related study issues, anticipate potential issues (sharing lessons learned) across the project or study teams.
Medical Scribe - Orthopedics Per Diem Lahey Hospital and Medical CenterMedical Scribe - Orthopedics Per DiemBoston, MA$19–$21 / hourCustomer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Written Communications: Ability to read, and write in English in order to understand basic safety instructions and take direction from supervisors; communicate effectively with patients, families and other medical center staff; and respond to basic questions.
NewMedical Scribe Tufts MedicineMedical ScribeBoston, MAAt the direction of a physician or licensed independent practitioner, the duties of the position are to document the physician dictated patient history, review of systems, medications and allergies, physical examination, family, social and past medical history as well as to document procedures, lab results, dictated radiographic impressions made by the supervising physician and other information pertaining to the patient's encounter in the outpatient clinic. In addition, this role focuses on performing the following General Administration duties: Produces documents, collects, records, sorts and files information, handles mail, prepares routine reports, makes travel arrangements, arranges appointments, responds to inquiries, data entry, and operates office equipment.
Referral Specialist Brown University HealthReferral SpecialistProvidence, RI$19.03–$31.39 / hourBrown University Health employees are expected to successfully role model the organization''s values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. Acts as a liaison/resource with patients, referring providers, community providers and practice team members regarding referral issues utilizing the highest level of customer service.
Registered Nurse Supervisor, Clinical Trauma Registry, 40 Hours (Days) Boston Medical CenterRegistered Nurse Supervisor, Clinical Trauma Registry, 40 Hours (Days)Boston, MA$89,500–$130,000 / yearKey responsibilities include maintaining data integrity through concurrent abstraction, validation, and audit readiness; managing the trauma registry software in partnership with the vendor and BMC ITS; and implementing required updates from ACS, TQIP, NTDB, and MA DPH. This role supervises five trauma registrars, prioritizes daily workflow, and ensures full compliance with all state and national reporting requirements, including submissions to NTDB/TQIP and the Massachusetts Department of Public Health Trauma Registry.
Outpatient Coder II UMass Memorial HealthOutpatient Coder IIWorcester, MassachusettsAdheres to the coding and billing regulations established by the American Hospital Association (AHA), American Medical Association (AMA), and Centers for Medicare and Medicaid Services (CMS). Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve.
Associate Medical Director of Clinical Practice and Education Greater New Bedford Community Health Center, IncAssociate Medical Director of Clinical Practice and EducationNew Bedford, MADemonstrated ability to educate, mentor, and support physicians, advanced practice providers, residents, students, nurses, and other clinical staff through bedside teaching, procedural instruction, case consultation, and constructive feedback to promote high-quality, evidence-based patient care. Educate and empower patients and families by providing culturally responsive education regarding diagnoses, treatment options, medications, preventive care, and healthy lifestyle behaviors to support informed decision-making and self-management.
Senior Director, Field Reimbursement Alexion Pharmaceuticals IncSenior Director, Field ReimbursementBoston, MAProven experience creating and managing compliant field-based reimbursement and access teams, including key account targets, size, structure, strategy, programs/initiatives, compliance requirements (PHI), KPIs, analytics, integration with patient support services. Superb knowledge of government and commercial payers for specialty products (rare disease) across buy & bill and specialty pharmacy pathways, prior authorization and appeal requirements, coding, appropriate claim submission, and integration with patient assistance programs.
Surgical Services Coordinator II - New England Eye Center - Boston Tufts MedicineSurgical Services Coordinator II - New England Eye Center - BostonBoston, MA$21.53–$26.91 / hourThis position monitors and coordinates all surgical scheduling functions for the department, including answering patient inquiries, initial patient interviews, scheduling and facilitating surgical dates with patients and families or other support systems as noted, assuring surgeon preferences regarding surgical sites, assistants, processes and any additional materials necessary to properly support specific resources. In addition, this role focuses on performing the following General Administration duties: Produces documents, collects, records, sorts and files information, handles mail, prepares routine reports, makes travel arrangements, arranges appointments, responds to inquiries, data entry, and operates office equipment.
Associate Director, Medical Review Lead, MSRM Agios Pharmaceuticals IncAssociate Director, Medical Review Lead, MSRMCambridge, MA$185,369–$308,948 / yearThe current base salary range for this position is expected to be between $185,369 and $308,948 annualized; final salary will be determined based on various factors including, but not limited to, years of relevant experience, job knowledge, skills and proficiency, degree/education, and internal comparators. This role provides oversight of medical review for Individual Case Safety Reports (ICSRs) across investigational and marketed products, ensuring medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance and risk management activities.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DORI$174,070–$374,920 / yearThe Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in managing oncology specific utilization of providers, clinical reviews of oncology specific data, and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight for medical policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases.
Associate Director, Medical Review Lead, MSRM - Remote Agios PharmaceuticalsAssociate Director, Medical Review Lead, MSRM - RemoteBoston, MARemote$185,369–$308,948 / yearThe current base salary range for this position is expected to be between $185,369 and $308,948 annualized; final salary will be determined based on various factors including, but not limited to, years of relevant experience, job knowledge, skills and proficiency, degree/education, and internal comparators. This role provides oversight of medical review for Individual Case Safety Reports (ICSRs) across investigational and marketed products, ensuring medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance and risk management activities.
Associate Medical Director, Pharmacovigilance Tango TherapeuticsAssociate Medical Director, PharmacovigilanceBoston, MA$194,400–$291,600 / yearThis includes expanding the universe of precision oncology targets into novel areas such as tumor suppressor gene loss and their contribution to the ability of cancer cells to evade immune cell killing. Author robust and medically sound company comments for ICSRs, clearly documenting the company's medical assessment, clinical rationale, causality considerations, relevant medical history, alternative etiologies, and overall safety evaluation, as applicable.
Associate Medical Director, Pharmacovigilance Tango Therapeutics IncAssociate Medical Director, PharmacovigilanceBoston, MA$194,400–$291,600 / yearThis includes expanding the universe of precision oncology targets into novel areas such as tumor suppressor gene loss and their contribution to the ability of cancer cells to evade immune cell killing. Author robust and medically sound company comments for ICSRs, clearly documenting the company''s medical assessment, clinical rationale, causality considerations, relevant medical history, alternative etiologies, and overall safety evaluation, as applicable.