Top Healthcare Services Jobs in Boston, MA

The Sr. Compliance Reporting Analyst performs audits and compliance reporting, ensuring adherence to regulations while managing quality assurance and data analysis for process improvement.

The Payment Selections Manager leads the identification and recovery of improper claim payments, collaborates with cross-functional teams, and improves payment integrity processes while conducting data analysis and audits.

The Associate Medical Director oversees clinical reviews for orthopedic services, ensuring evidence-based guidelines are applied and communication is effective. Responsibilities include peer discussions for clinical clarity, documentation, and supporting operational improvements, requiring extensive experience in orthopedic surgery and managed care.

This role involves reviewing clinical information, providing medical determinations in Cardiovascular Medicine, and ensuring high-quality patient outcomes through evidence-based guidelines. The Medical Director collaborates with teams to enhance clinical practices and manages operational improvements.

The Medical Director, Clinical Strategy leads clinical program design and strategy, collaborating cross-functionally to meet client needs and support growth initiatives.

Lead the auditing team to ensure quality control in healthcare payment services. Manage audits, team training, and compliance with coding guidelines while engaging with internal and external stakeholders.

The Clinical Quality and Training Specialist will conduct quality audits, deliver training, analyze QA findings, and support clinical performance improvements.

As a Claims Auditor, you will conduct MS-DRG and APR-DRG coding reviews, ensuring the accuracy of claims to maximize overpayment identification while adhering to coding guidelines and compliance regulations.

As a Clinical Policy Configuration Specialist, you'll configure medical coverage policies, conduct quality assurance, and collaborate with cross-functional teams to ensure compliance and support effective healthcare delivery.

The RN Reviewer performs medical necessity reviews, collaborates with providers, documents accurately, and identifies opportunities for improvement in healthcare delivery.