Top Healthcare Services Jobs in Boston, MA

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

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.

Supervise and develop an RN Reviewer team, manage daily operations and productivity, ensure timeliness and quality metrics, lead meetings, train new RNs, capture process improvements, and report performance to Clinical Operations leadership.

The Associate Medical Director will review clinical information, support quality improvement in patient care, and manage clinical decisions based on evidence-based guidelines, while ensuring effective communication and documentation.