- Segal (Boston, MA)
- …The Role:The role of a Consulting Actuary includes client management, project management, technical review, subject matter expertise and new business development. ... GASB 74/75 (or 67/68) is preferred and experience developing or reviewing claims costs is preferred;Experience reviewing OPEB liabilities is preferred and ability to… more
- Humana (Boston, MA)
- …independent determination of the appropriate courses of action. **Where you Come In** As a Claims Process Organization Project Manager II you will manage ... caring community and help us put health first** The Project Manager II manages all aspects of a ... + Communicate with other operational areas in the organization to secure specialized resources and contributions for the… more
- Commonwealth Care Alliance (Boston, MA)
- …corresponding business vertical(s). + Oversee the entire product development process , including estimation of product costs, coordination between senior management ... and vendor partners. + Review and approve all engineering estimates supporting IT project delivery for the platform(s). + Advise and approve the integration designs… more
- Humana (Boston, MA)
- …career to the next level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional, you will play a pivotal ... in resolving outstanding balances related to claim reversals, all while leading process improvements and influencing departmental strategies. This is your chance to… more
- Tufts Medicine (Burlington, MA)
- …Access, Project Management software. 3. Strong technical, analytical, problem-solving, project management skills. 4. Knowledge of organization and project ... of information technology (IT) solutions in order to meet the organization 's needs through new and existing applications, systems architecture, network systems… more
- Burns & McDonnell (Newton, MA)
- …contracts, CM contracts, subcontracts, and change orders. + Participate in risk review process . + Implement assigned sections of the Project Execution Plan, ... execution, construction quality assurance plan, safety & health plan, subcontracting plan, project staffing plan, organization chart, and procurement plan. +… more
- Stantec (Boston, MA)
- …move-in activities + Review all invoices and change orders associated with the project + Assist in resolving disputes and claims **Qualifications** **Your ... Assistant Project Manager - ( 240003DK ) **Description** We're...plan, and implement projects that help them achieve their organization 's objectives. Our award-winning team has managed thousands of… more
- Tufts Medicine (Boston, MA)
- …duties: Facilitates the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers about submitted ... claims , and performs appeals for non-clinical denials, etc. An...hospital and professional billing background, as well as prior project coordination and administrative support. **Preferred Qualifications** **:** 1.… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery Analyst will assist in the ... for a comprehensive claim accuracy program. The individual will optimize pre/post claims auditing and claim recovery programs that will drive incremental value year… more
- Commonwealth Care Alliance (Boston, MA)
- …Master, you will facilitate and coordinate Agile Scrum processes within our organization , ensuring the company can work collaboratively and efficiently to deliver ... practice, and guidelines. + Coaches the Scrum team in self- organization , cross-functional skillset, domain knowledge and communicates effectively, both internally… more
- American Heart Association (Boston, MA)
- …such as code book, Case Report Forms, Surveys, EHR queries and other data project documentation process . + Develop and implement guidelines to manage data ... for you to be able to integrate data from different sources (clinical, claims , patient-reported survey data, food vendors). The Database Designer is responsible for… more
- Turner & Townsend (Boston, MA)
- **Company Description** From the inception of a project through to completion and beyond, Turner & Townsend help to deliver the outcomes that matter through ... transformational programs covering the full spectrum of consultancy, project delivery and post- project operations. With offices located globally, you're never… more
- Guardian Life (Boston, MA)
- **Job Posting Title** **Team Leader, Absence Claims Management** **Job Description** The **Team Leader, Absence Claims Management** is responsible for leading a ... Managers to get results within their team and the organization . The Team Leader will serve as a primary...action plans for improvement. + Review processes/reports regularly for process improvement opportunities. + Own relationship with client and… more
- Norstella (Boston, MA)
- …Now, Citeline is proud to be a part of Norstella, an organization that consists of market-leading pharmaceutical solutions providers united under one goal: ... to improve patient access to life-saving therapies. Within this organization , Citeline plays a key role in helping clients connect the dots from pipeline to patient.… more
- State of Massachusetts (Boston, MA)
- …Administrator contractual functions that relate to provider enrollment and credentialing, claims operations, appeals, program integrity and reporting related to the ... (TPA) contractual functions relating to provider enrollment and credentialing, claims operations, prior authorization, appeals, program integrity and reporting… more
- Burns & McDonnell (Newton, MA)
- … Execution Plan, Quality Assurance Plan, Safety & Health Plan, Subcontracting Plan, Project Staffing Plan, Organization Chart, and Procurement Plan. + Contribute ... Request for Information (RFI's), submittals, meeting minutes, change management, and claims mitigation. + Support project cost reporting, scheduling, work… more
- Bank of America (Boston, MA)
- …use a multi-faceted approach for flexibility, depending on the various roles in our organization . Working at Bank of America will give you a great career with ... As a Fraud Strategy Manager with the Client Protection organization , you will capitalize on technical abilities and strategic...fraud requirements, testing, and development of strategies for new project and endeavors + Lead the team to develop,… more
- Deloitte (Boston, MA)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Deloitte (Boston, MA)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Burns & McDonnell (Newton, MA)
- … Execution Plan, Quality Assurance Plan, Safety & Health plan, Subcontracting Plan, Project Staffing Plan, Organization Chart, and Procurement Plan. + Assist ... required. + Assist with the Prime Contract, subcontractor, and supplier invoicing process . + Establish and administer project documentation and filing systems.… more
