- Mathematica (Boston, MA)
- …https://www.mathematica.org/career-opportunities/benefits-at-a-glance. Mathematica is looking for a highly organized Medicaid Project Associate to contribute ... and support the work of projects in the Federal Medicaid practice. As a part of a project team, the Associate will be responsible for coordinating and… more
- Abt Global Inc. (Cambridge, MA)
- …meaningful work? Now's your chance. **The Opportunity** Abt Global seeks an experienced Medicaid researcher (Senior Associate ) to play a leadership role in our ... technical programming staff to design and implement analyses using Medicaid claims and administrative data to meet project...to work effectively in a team environment. + Senior Associate Level: Master's degree + 13 years of relevant… more
- Humana (Boston, MA)
- …Fee Schedule Management System + Collaborate with Markets, Claims, Policy, Process and Project Managers to accommodate new Medicaid logic and identify the ... of our core cross-functional team responsible for ensuring timely and accurate Medicaid Physician reimbursement. The business needs of the team, Integrated Network… more
- Humana (Boston, MA)
- …and/or network management or provider relations experience. + 2+ years of project leadership experience + 2+ years of Medicaid experience/Managed Care ... part of our caring community and help us put health first** The Advisor, Medicaid Provider & Network Strategy will be accountable for leading the development of… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Medicaid Actuary role is responsible for providing actuarial support for multiple states in ... are the specific day to day responsibilities of the Medicaid Actuary role: + Frequent analysis of actual experience...of technical experience + 2 or more years of project leadership experience **Scheduled Weekly Hours** 40 **Pay Range**… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Physical Security Project Manager 2 will report to the Physical Security Lead and assist in managing ... protection of company assets through physical security projects. The Physical Security Project Manager 2 will be responsible for the design, implementation, and… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Project Management Lead manages all aspects of a project , from start to finish, so ... that it is completed on time and within budget. The Project Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial.… more
- Commonwealth Care Alliance (Boston, MA)
- …Enrollment reviews, this position will verify enrollment is entered correctly for Medicaid and Medicare effective dates. This position will also conduct reviews to ... is complete. **Claims Review** + Understand all claim processing related requirements from Medicaid and Medicare for all CCA offered products. + Conduct reviews of… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Associate Director of Contractor Workforce Management will drive a best-in-class contractor workforce ... program. Reporting directly to the Associate Vice President of Source to Pay Operations you...multi-faceted and often ambiguous data + Ability to motivate project team members and stakeholders to meet established deadlines… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex… more
- Commonwealth Care Alliance (Boston, MA)
- …maintenance and enhancement of an effective Compliance Risk Assessment Program + Project manage regulator and other external reviews as assigned + Contribute towards ... impact on the Annual Internal Audit Plan or Annual Compliance Monitoring Plan. ** Project manage regulator and other external reviews as assigned** + Lead the… more
- Harvard University (Cambridge, MA)
- Details Title Research Associate /Data Analyst School Harvard School of Dental Medicine Department/Area Oral Health Policy and Epidemiology Position Description We ... The person will be responsible for completion of these tasks within project timelines and must ensure the integrity of data collection, review, compilation,… more
- Highmark Health (Boston, MA)
- …underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change management ... the most complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate high-level… more
- Humana (Boston, MA)
- …+ Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if there are concerns ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees… more
- Humana (Boston, MA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Boston, MA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Boston, MA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Boston, MA)
- …Leads projects of high sensitivity/confidentiality + Report out SLA performance and project delivery to key stakeholder groups and prepare remediation plans when ... leadership on a weekly basis. + Leads continuous improvement initiatives for project management and delivery. + Has overall responsibility for service issue… more
- Humana (Boston, MA)
- …analytic solutions. The Stars program is the Centers for Medicare & Medicaid Services (CMS) five‐star quality rating system for measuring Medicare beneficiaries' ... improve the decision-making experience for stakeholders + 2 or more years of project leadership experience + Experience analyzing data to solve a wide variety of… more
- Humana (Boston, MA)
- …+ Master's Degree or higher in Computer Science or a related field + Associate or Professional level solution architecture certification in Azure, GCP and/or AWS. + ... in Enterprise Architecture repository tools like iServer + 2+ years of project leadership and consulting experience. + Health Care Business Domains - Medicare,… more