- 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
- 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
- Humana (Boston, MA)
- …community and help us put health first** Humana Healthy Horizons is seeking a Senior Medicaid Provider Education Professional to drive best in class provider ... Provider Education team through collaboration across existing and new Medicaid markets. The Senior Medicaid ...create provider materials, has interpersonal skills to work across business segments, and must be highly organized. **Key Role… more
- Public Consulting Group (Boston, MA)
- Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human ... and regulation. + Reviews and is an expert in business operations for service and efficiency improvements. + Develops...such as 1915(c), 1915(i), 1915(j), and 1915(k), along with Medicaid State Plan benefits, PACE, SNFs, and ICF-IID. Knowledge… more
- Humana (Boston, MA)
- …scope while aligned to enterprise objectives. 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)
- … business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work ... business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work… more
- Humana (Boston, MA)
- …us put health first** Humana's Marketing Organization is seeking an experienced Senior Production Professional, Dialogue Developer to join the Exstream Dialogue team ... working remote anywhere in the US. As the Senior Professional, you will contribute to the development of...You will work closely with product managers and Humana business units with the need to be receptive to… more
- Humana (Boston, MA)
- …Coordinate business partner engagement with external regulators + Coordinate implementation and compliance with corrective action plans, as needed + Provide ... a part of our caring community and help us put health first** This Senior Compliance Professional role supports Humana's suite of Medicare and Commercial Dental and… 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
- Commonwealth Care Alliance (Boston, MA)
- …Important to Us:** **Position Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery ... strategies to avoid future overpayments/underpayments, and implement plans to achieve business goals. **Supervision Exercised:** + No, this position does not have… more
- Prime Therapeutics (Boston, MA)
- …Create and maintain strategic partnerships with customers through the development and implementation of annual account work plans, retention and growth plans that ... Other duties as assigned **Minimum Qualifications** + Bachelor's degree in Finance, Business , Health Care Administration or related area of study, or equivalent… more
- Takeda Pharmaceuticals (Boston, MA)
- …solutions that ensure patient access to Takeda therapies. As a key member of the Senior US Oncology Leadership team, the Head of US Oncology Patient Value and Access ... of Patient Value and Access for the US Oncology Business Unit (US OBU), you will lead and direct...development of value driven optimal pricing strategies and oversee implementation of pricing activities consistent with the strategy including… more
- Humana (Boston, MA)
- …that put patients at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of home health services, and ... in their personal and professional well-being, all from day one. The Home Solutions business segment is comprised of two major brands - CenterWell Home Health (CWHH)… more
- Commonwealth Care Alliance (Boston, MA)
- …functions. + Leads in collaboration with the CISO and relevant functional business owners, the review, development, implementation and ongoing compliance ... and standards. The CPO oversees and manages the strategy, planning, implementation , oversight, auditing, monitoring, and ongoing operation of CCA's privacy and… more
- State of Massachusetts (Boston, MA)
- …is led by the Director of Program Integrity, who reports to the Deputy Medicaid Director, and consists of 10 internal staff members and dozens of contractors ($50M ... success. The Deputy Director will focus on the identification, development and implementation of innovative program integrity solutions to achieve the agency's dual… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …healthcare? Bring your true colors to blue. The Role Reporting to Senior Vice-President of Government Programs, the VP Product is responsible for developing ... result in achieving membership and margin targets for the Government Line of Business . This leader will work with internal partners (including Sales and Marketing,… more
- Humana (Boston, MA)
- …. + Strong analytical and strategic thinking skills, with the ability to influence senior leaders across both the business and technology. + Proven track record ... devises an effective strategy for executing and delivering on IT business initiatives. The Associate VP, Technology Solutions requires a in-depth understanding… more
- Commonwealth Care Alliance (Boston, MA)
- …services and long term services and supports to ensure achievement of business results while maintaining compliance with all contract requirements, state and federal ... responsible for setting strategic direction, planning, budgeting, policy development and business process management and improvement for all UM functions. This role… more