- Sedgwick (Boston, MA)
- …Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Manager | VA Jurisdiction | Remote **PRIMARY PURPOSE** : To manage the ... + Establishes policy and procedure to assure compliance to best practices, claims management services standards, state regulations and client service requirements. +… more
- Elevance Health (Boston, MA)
- **Anticipated End Date:** 2024-09-09 **Position Title:** Rating/ Claims System Senior Advisor **Job Description:** **Rating/ Claims System Senior Advisor** ... **Location:** This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint… more
- Sedgwick (Boston, MA)
- …and support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker , attorney and supervisor. + Identifies ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured … more
- Takeda Pharmaceuticals (Lexington, MA)
- …of my knowledge. **Job Description** About the role: Join Takeda as a Senior Manager , US Medical Ad/Promo Regulatory Review where you will serve as an internal ... of advisory comments and any other interactions regarding use of promotional claims for assigned products. + Ensure review standards within the electronic approval… more
- Elevance Health (Woburn, MA)
- **Anticipated End Date:** 2024-09-17 **Position Title:** Account Service Manager **Job Description:** **Account Service Manager ** **Location: Must be within 50 ... miles of any location listed; position has both office/ remote expectations.** AmeriBen is a proud member of the Elevance Health family of companies. We are a… more
- Elevance Health (Woburn, MA)
- **Anticipated End Date:** 2024-09-23 **Position Title:** CarelonRx Account Manager II **Job Description:** **CarelonRx Account Manager II** **Location:** This ... position will work a hybrid model ( remote and office). The ideal candidate must live within...PulsePoint locations listed on the requisition. The **CarelonRx Account Manager II** is responsible for retention and operational excellence… more
- Elevance Health (Woburn, MA)
- …Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from our ... of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you… more
- State of Massachusetts (Boston, MA)
- …all aspects of the Family and Medical Leave Program relating to claims application processing. This includes managing the overall activities and functions of ... and maintain processes both internal and external to our claims management system that are compliant with state laws...report to and work closely with the DFML Senior Manager of Operations and Program Integrity, as well as… more
- Elevance Health (Woburn, MA)
- …Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one the ... to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Woburn, MA)
- …Investigator II **Job Description:** **Location:** This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
- Elevance Health (Woburn, MA)
- …in-office) with PulsePoint sites used for collaboration, community, and connection. This includes remote work and 1-2 days in office per week. Candidates must reside ... increments or decrement. + Communicates with sales, administration and claims to assess the rating and administrative impact or...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Woburn, MA)
- …**Pharmacy Quality Improvement Specialist** _This position will work a hybrid model ( remote and office), 1-2 times per week. The Ideal candidate will live ... plus. + Previous experience in high-volume operations (Medical Review, Appeals, Claims , Customer Service) strongly preferred. + Working Specialty or Front-end… more
- Elevance Health (Newton, MA)
- …**Associate Research Director** **Location:** This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of ... + Extensive experience conducting research using healthcare databases (ie administrative claims data) strongly preferred + Expertise in data science and analytic… more
- Elevance Health (Newton, MA)
- …Senior - Health Services Research** **Location:** This position will work a hybrid model ( remote and in office one day per week). Ideal candidates will live within ... requirements to the programming group. + Conduct analyses of administrative claims /electronic medical records/survey data and review of statistical output to ensure… more