PFS Denial Specialist 3 Lahey Hospital and Medical CenterPFS Denial Specialist 3MA$24.15–$32.50 / hourWorking in an SBO (Single Billing Office), environment the Denial Specialist 3 will need to know Hospital and Professional Billing to assist customers with questions and accurate registration of insurance and or processing physician billing denials. Provides support for the mentoring and training of new and end existing A/R staff as required following the training program set forth to include but not limited to policy and procedures, EHR system functionality, audits and staff reviews.
Professional Coder, ObGyn Lahey Hospital and Medical CenterProfessional Coder, ObGynBoston, MA$27.03–$43.25 / 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. This coder will help support providers and operations during the upcoming 2027 obstetric CPT coding updates, ensuring accurate billing, regulatory compliance, and provider training.
Office Support Specialist I - Medical Records - Recovery from Addictions Program Commonwealth of MassachusettsOffice Support Specialist I - Medical Records - Recovery from Addictions ProgramTaunton, MAOffice Support Specialist I'',''Office Support Specialist I'',''United States-Massachusetts-Taunton-60 Hodges Avenue'',''United States-Massachusetts-Taunton-60 Hodges Avenue'',''Administrative Services'',''Administrative Services'',''Department of Mental Health'',''Department of Mental Health'',''Full-time'',''Full-time'',''Day'',''Day'',''Aug 25, 2026, 2:15:29 PM'',''Aug 25, 2026, 2:15:29 PM'',''1'',''1'',''81,582.28'',''57,865.34'',''81,582.28'',''Yearly'',''Christina The selected candidate's main function will be the daily census, but will perform a variety of administrative functions including, but not limited to, answering phones; printing ID cards; auditing MHIS activity; analyzing inpatient and discharge medical records for compliance with RAP, Joint Commission, and DMH requirements; responding to requests for information in a timely manner; and providing back up support to OSS I for SLS (Safety Learning System - Datix) and OSS II in absence of both.
Associate Director, Medical Review Lead, Msrm Agios PharmaceuticalsAssociate 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.
Senior Manager, Insurance and Claims Advocacy Sun Life Financial IncSenior Manager, Insurance and Claims AdvocacyWellesley Hills, MA$76,200–$114,300 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Clinical Scientist, Associate Director Candel TherapeuticsClinical Scientist, Associate DirectorNeedham, MA$181,000–$194,000 / yearCandel Therapeutics is seeking an experienced and intellectually curious Clinical Scientist to support our oncology clinical development programs, with an initial focus on prostate cancer and opportunities to contribute across additional solid tumor programs, including lung and brain cancer studies. Author and contribute to key clinical and regulatory documents including Clinical Study Reports (CSRs), Investigator Brochures (IBs), protocols, informed consent forms (ICFs), DSURs, clinical narratives, and IND/BLA regulatory submissions.
Director of Community Geriatrics - Full-Time | Lead & Transform Senior Care The Staff PadDirector of Community Geriatrics - Full-Time | Lead & Transform Senior CareBoston, MassachusettsWe are seeking an experienced, board-certified primary care physician with strong geriatric experience to join the multidisciplinary team as Director of Community Geriatrics in Boston, MA, providing clinical leadership, direct patient care, and oversight of advanced practice providers and senior living programs. If you are a board-certified/eligible primary care physician with strong geriatric experience and are ready to take on a leadership role while making a meaningful impact on the care of older adults, we invite you to apply today!
Sr Utilization Management Nurse RN - Field Position UnitedHealth Group Inc.Sr Utilization Management Nurse RN - Field PositionBoston, MA$72,800–$130,000 / yearAs a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring the accuracy of medical record coding, supporting proper payment to nursing facilities, and promoting quality patient care. Required to travel within geographic territory (state of Massachusetts) at least 90% of the time (some weeks will require 100% travel as business needs dictate) and assist when needed throughout the state of Massachusetts for audits.
Senior Principal AI Engineer Vertex PharmaceuticalsSenior Principal AI EngineerBoston, Massachusetts$188,000–$282,000 / yearWorking within the Agentic AI Platform team, thisrole will focus on delivering production-grade platform services for model integration, prompt and workflow orchestration, evaluation, observability, performance optimization, and agent lifecycle management. Own thedeveloper experiencefor the platform, delivering intuitive self-service onboarding, SDKs, CLIs, sandbox environments, reference implementations, and clear documentation that let builders move from idea to production quickly.
Summer Intern 2027 - AI ManulifeSummer Intern 2027 - AIBoston, MassachusettsYou’ll receive guidance from experienced practitioners while gaining exposure to the end-to-end lifecycle of data science, machine learning, and emerging AI solutions in an enterprise environment. As part of our internship program, you will gain early access to Manulife John Hancock’s premier early talent program, GRO, tailored to graduating students!
Associate Director, Bioinformatics Rhythm PharmaceuticalsAssociate Director, BioinformaticsBoston, MARemoteFull timeA core focus of this position will be the development and implementation of algorithmic phenotyping approaches using electronic medical records (EMR) and real-world datasets, enabling robust patient stratification, cohort definition, and integration with genomics and biomarker data. We are seeking a highly motivated Associate Director of Bioinformatics within Rhythm's Research group to support of our clinical, regulatory, and scientific objectives in the rare neuroendocrine/obesity/metabolic disease therapeutic area.
Senior Clinical Pharmacist, COMM and Exchange Mass General BrighamSenior Clinical Pharmacist, COMM and ExchangeSomerville, Massachusetts$134,316–$164,087.04 / yearo* Develops, implements, and leads managed care programs such as prior authorization and quantity limitations programs o* Ensures clinical compliance with law and regulatory bodies o* Develops educational materials, newsletters, member, and provider talking points, and disseminates clinical information for both internal and external audiences. -Formulary trend management: o* Develops and implements clinical pharmacy strategies which result in high-quality, cost-effective pharmacy management and outcomes o* Develops, analyzes, reports on clinical programs, handles, and coordinates between Pharmacy and other collaborators throughout Mass General Brigham Health Plan.
Grievance and Appeals Coordinator (44872) Neighborhood Health Plan of Rhode IslandGrievance and Appeals Coordinator (44872)Smithfield, RIThe Coordinator maintains organized and secure record-keeping systems, communicates effectively with internal and external stakeholders, and fosters collaborative relationships across departments to ensure compliance and exceptional service. This role ensures timely and compliant correspondence to members and providers, monitors case progress, and alerts staff when deadlines approach.
Manager, Pharmacovigilance Case Processing Les Laboratoires Servier SASManager, Pharmacovigilance Case ProcessingBoston, MA$131,000–$150,000 / yearMonitoring Outsourced Activities & Case Management: Manage pre- and post-marketing pharmacovigilance cases processed by Service provider: book-in, data entry, coding, narratives, quality control, medical review, and submission of applicable cases. The Manager, Pharmacovigilance Case Processing is responsible for overseeing the end-to-end management of pharmacovigilance cases outsourced to a vendor, encompassing activities from initial collection to final submission.
Clinical Scientist, Associate Director Candel Therapeutics IncClinical Scientist, Associate DirectorNeedham, MA$181,000–$194,000 / yearCandel Therapeutics is seeking an experienced and intellectually curious Clinical Scientist to support our oncology clinical development programs, with an initial focus on prostate cancer and opportunities to contribute across additional solid tumor programs, including lung and brain cancer studies. Author and contribute to key clinical and regulatory documents including Clinical Study Reports (CSRs), Investigator Brochures (IBs), protocols, informed consent forms (ICFs), DSURs, clinical narratives, and IND/BLA regulatory submissions.
NewDirector of Revenue Cycle VITRA HealthDirector of Revenue CycleBoston, MA$160,000–$180,000Partner with the Compliance function on all billing-related matters, ensuring that MassHealth Adult Foster Care (AFC) and Group Adult Foster Care (GAFC) billing practices adhere to 130 CMR 408.000 and 130 CMR 450.000, including conditions for payment, prior authorization, non-covered days, medical and nonmedical leave-of-absence limits, and supporting documentation requirements, and engage Compliance in the review of billing policies, void and adjustment activity, and any identified billing irregularities. Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment.
APP - Nurse Practitioner Or Physician Assistant ConcertoCareAPP - Nurse Practitioner Or Physician AssistantProvidence, RI$130,000–$160,000 / yearThis is an ideal position for a clinician who seeks an opportunity for "top of license" practice, enjoys a collaborative team-based approach to care, and is excited to engage in developing and nurturing our innovative, value-based clinical model focused on caring for patients with complex needs who are inadequately served by traditional healthcare delivery systems. This exciting role allows you to deliver clinical care flexibly through a blend of in-person care delivery at your patient's home and virtual care delivery from your own home, with the support of nurses, community health workers, medical assistants, nurse case managers, clinical social workers, and clinical pharmacists.
Registered Nurse Supervisor (Home Health Assessments) Activate CareRegistered Nurse Supervisor (Home Health Assessments)Boston, MAThe RN Supervisor leads a distributed team of RN Assessors who travel to members' homes across Massachusetts to complete in-person health assessments for a managed care health plan's dually eligible members. Conduct rigorous pre-submission audits of assessments (Uniform Core, Functional, and Comprehensive), coding, and SOAP notes to intercept errors before final submission to the health plan's review team.
Registered Nurse Supervisor ( Home Health Assessments) Activate CareRegistered Nurse Supervisor ( Home Health Assessments)Boston, MAThe RN Supervisor leads a distributed team of RN Assessors who travel to members' homes across Massachusetts to complete in-person health assessments for a managed care health plan's dually eligible members. Conduct rigorous pre-submission audits of assessments (Uniform Core, Functional, and Comprehensive), coding, and SOAP notes to intercept errors before final submission to the health plan's review team.
Clinical Documentation Specialist II- RN- Remote Lahey Hospital and Medical CenterClinical Documentation Specialist II- RN- RemoteBurlington, MARemote$125,000–$160,000 / yearThe Clinical Documentation Improvement (CDI) Specialist II assists with the appropriate identification of diagnoses, conditions, and/or procedures that are representative of the patient's hospital stay and care provided including Severity of Illness (SOI), Risk of Morality (ROM), during an inpatient hospitalization. CDI Specialist II initiates concurrent queries to providers as supported by medical record documentation to improve the accuracy, integrity, and quality of patient data, and drive improvement toward quality physician documentation within the body of the medical record.