• Member Services

    Point32Health (Canton, MA)
    …expected to identify opportunities to improve customer service and efficiency. The Member Services Representative is expected to take responsibility for ... enjoy the important work we do every day in service to our members, partners, colleagues and communities. To...the general direction of the Call Center Supervisor, the Member Services Representative is responsible… more
    Point32Health (09/28/24)
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  • SCA Provider Enrollment Representative I

    Elevance Health (Hingham, MA)
    …NGS and/or Elevance Health office locations listed on this requisition. **National Government Services ** is a proud member of Elevance Health's family of brands. ... **SCA Provider Enrollment Representative I** **Locations:** This is a virtual role;... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal… more
    Elevance Health (10/04/24)
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  • Inbound Contacts Representative - Remote

    Conviva (Boston, MA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... caring community and help us put health first** The Inbound Contacts Representative represents the company by addressing incoming telephone, digital, or written… more
    Conviva (08/09/24)
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  • Oncology Sales Representative /Specialist…

    Merck (Boston, MA)
    …with a driven, customer-focused and collaborative team. As an Oncology Sales Representative /Specialist, you will be a key member partnering with customers ... Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more. **Qualifications:** **Minimum Requirements:** +… more
    Merck (09/27/24)
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  • Pharmacy Operations Representative

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …software. + Support new clinical program implementation + Serve as a liaison to Member Services and other internal clients for real-time support on pharmacy ... computer systems against our Medical Policy Criteria + Review and interpret member 's eligibility, claim history, and Pharmacy Program information using the PBM… more
    Blue Cross Blue Shield of Massachusetts (10/04/24)
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  • Social Worker II - Framingham- Growing PACE…

    Fallon Health (Framingham, MA)
    …**About Fallon Health** Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. ... health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care...we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and… more
    Fallon Health (09/18/24)
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  • Registered Nurse (RN) Utilization Nurse Reviewer…

    Commonwealth Care Alliance (Boston, MA)
    …Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, ... clinical areas, including but not limited to surgical procedures, Medicare Part B medications, Long Term Services ...+ RN license in the state applicable to the member 's services , active nursing license in good… more
    Commonwealth Care Alliance (10/03/24)
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  • Sr. Director, Regulatory Compliance

    HealthEdge Software Inc (Boston, MA)
    …govern them: NCQA (National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services ), URAC (Utilization Review Accreditation Commission) ... engineers, and healthcare industry experts ensure our patented technology works in service of the person-to-person connections that make healthcare work best. The… more
    HealthEdge Software Inc (09/06/24)
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  • Appeals & Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    …to: quality; regulatory affairs/compliance; clinical, operations, pharmacy, dental, reporting, and member services . - Supports the Senior Appeals & Grievance ... Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age,… more
    Commonwealth Care Alliance (09/07/24)
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  • Physician

    North Shore Community Health (Peabody, MA)
    …of the Primary Care Team (PCT) as a leader and an engaged team member . The Organization North Shore Community Health (NSCH) is a highly accomplished community health ... strong commitment to excellence, NSCH provides: * Comprehensive primary care. * Dental services . * Behavioral health care. * Care management. * Pharmacy services more
    North Shore Community Health (07/30/24)
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  • Product Manager

    HealthEdge Software Inc (Boston, MA)
    …payment integrity, and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration ... digital transformation, reduce costs, and improve both clinical outcomes and the member experience. **Your impact** **:** + **Product Strategy and Vision:** Support… more
    HealthEdge Software Inc (09/11/24)
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