- Humana (Boston, MA)
- …caring community and help us put health first** Humana Healthy Horizons is seeking a Medicaid Implementation Senior Business Project Manager to manage a ... change management and project management are best suited for this role. The Medicaid Implementation Senior Business Project Manager will serve as a… more
- Commonwealth Care Alliance (Boston, MA)
- …is Important to Us:** **Position Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... Sr . Analyst will be responsible for developing prospective claims...applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- Prime Therapeutics (Boston, MA)
- … business (Employer Markets, Health Insurance Marketplace, Commercial, Medicare, Medicaid , Specialty) or with unique Prime contract requirements; drive the ... we make. **Job Posting Title** Health Plan Account Dir Sr - Remote **Job Description** The Sr ...advanced degree + Experience working within assigned line of business or market segment (Commercial, Medicare, Medicaid ,… more
- Prime Therapeutics (Boston, MA)
- …passion and drives every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible ... and participates in committee review meetings within the Commercial, Medicare, Medicaid , and Health Insurance Marketplace for the assigned department. This position… more
- Humana (Boston, MA)
- …Medicaid products and capabilities to support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for ... Care Organization **OR** 2+ years of experience in strategy consulting supporting Medicaid managed care organizations. + Experience in business development or… more
- Public Consulting Group (Boston, MA)
- …and Grants Management + Assessments and Feasibility Studies PCG is looking for a Senior Consultant in Medicaid policy and funding as it relates to children's ... Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health,...children's behavioral health services. PCG is looking for a Senior Consultant in Medicaid policy and funding… more
- Prime Therapeutics (Boston, MA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Sr . Director, Pharmacy Network Management - Remote **Job Description** The Senior ... market leading pharmacy reimbursement methodologies that support all of Prime's business assuring coordination with performance standards and corporate goals. + Lead… more
- Humana (Boston, MA)
- …an in-depth evaluation of variable factors. The Senior Technology Implementation Professional gathers and documents business system and functional ... a part of our caring community and help us put health first** The Senior Technology Implementation Professional delivers new technological solutions to meet … more
- WellSense (Boston, MA)
- …The Senior Contract Manager is responsible for the development, implementation and management of a cost-effective provider network, maintaining complex and ... Senior Contract Manager WellSense Health Plan is a...implementation ; . Knowledge of federal and state Medicare, Medicaid , and relevant guidelines, regulations and standards; . Effective… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Senior Business Systems Analysis Professional who is part of the System Optimization ... ensuring optimal performance and integration across the procurement landscape. The Senior Business Systems Analysis Professional performs analyses of systems,… more
- Point32Health (Canton, MA)
- …Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Compliance Senior Manager will report to the Government Programs Compliance Officer. ... regulators, serving as the primary liaison to address concerns and advance business and regulatory priorities. + **Policy Development:** Create and enforce policies,… more
- Center For Health Information And Analysis (Boston, MA)
- …and be a driving force in health policy impact! CHIA is seeking a Senior Health Policy Analyst to provide hands-on contributions in the development and ... implementation of data-driven pricing policy within the Provider Finance Pricing team. As a Senior Health Policy Analyst at CHIA, you will have the opportunity… more
- HealthEdge Software Inc (Boston, MA)
- **Overview** **Position Overview:** We are seeking a Senior Payment Integrity Specialist to play a key role in building and implementing proprietary healthcare edits ... in claims processing. The successful candidate will be responsible for taking a senior level role in analyzing claims data, as well as translating contract terms,… more
- Humana (Boston, MA)
- …our caring community and help us put health first** The Service Fund Senior Value-Based Programs Analyst supports our Market and Provider partners through ensuring ... with the Market partners to ensure understanding and accuracy. The Senior Value-Based Programs Analyst work assignments involve moderately complex to complex… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Senior IT Product Owner (PO) role is responsible for managing and communicating the vision ... to the team to determine the HOW. The role drives value to the business by building and maintaining a product backlog in collaboration with stakeholder and delivery… more
- Sanofi Group (Cambridge, MA)
- …for the company's products within the US for all of Sanofi's Pharma business [General Medicines & Specialty Care]. This senior leadership position will ... Legal, & Regulatory to ensure that pricing decisions support the company's business goals, market position, and compliance with regulatory requirements. The ideal… more
- State of Massachusetts (Boston, MA)
- …duties asrequired. Required Qualifications: * At leastfouryears ofproject management, implementation , business planning, or operations experiencepreferablyin a ... working with managed care organizations * More than 5 years of program, implementation , business planning, or operations experience in a healthcare environment.… more
- Prime Therapeutics (Boston, MA)
- …product domain and may align activities around a specific line of business (MedD, Medicaid , Health Insurance Marketplace, Commercial). **Responsibilities** + ... departmental strategy and new clinical product offerings (ie project representation across business units) + Represent the domain in partnership with key internal… more