- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Need As a core member of the Government Programs Star Performance team, the Medicare Stars Analyst provides ongoing analytic support to the development and ... the health plan's best in class 5-star strategy. In collaboration with the VP, Medicare Stars, this person will work with key stakeholders from across the company,… more
- Humana (Boston, MA)
- …necessary to support optimal value based care in accordance with Medicare and Humana policy. **Use your skills to make an impact** **Required Qualifications:** ... and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to… more
- Humana (Boston, MA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care… more
- Humana (Boston, MA)
- …is seeking an individual for the Senior Business Intelligence Data Analyst to provide support for its pharmacy programs to achieve success on the Service Fund ... for the Senior Business Intelligence Data Analyst to provide support for pharmacy programs, working heavily with...an upload speed of 10 Mbps is recommended to support Humana applications, per associate . + Wireless,… more
- Humana (Boston, MA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... of coding practices and clinical documentation, grievance and appeals processes (including pharmacy ), and reviews for DME, genetic testing, etc. within their scope.… more
- CenterWell (Boston, MA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... action plans to sustain improvement. + Oversee audit readiness for Medicare , Medicaid and commercial payers; ensure pre-billing activities meet compliance standards.… more
- CenterWell (Boston, MA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... and monitoring the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call Quality Professional is… more
- CenterWell (Boston, MA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF,… more
- CenterWell (Boston, MA)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management… more