- Humana (Boston, MA)
- …This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize, ... growth partners to design and optimize clinical operating model blueprints for viable Medicaid health plans that meet the needs of state clients and populations… more
- Humana (Boston, MA)
- …us put health first** Humana Healthy Horizons is seeking a Compliance Lead ( Medicaid State Reporting) to ensure compliance with governmental requirements for new ... Medicaid market implementations. This leader will work within specific...insurance, and/or financial services experience. + 2+ years of project /process leadership experience. + 4+ years of Compliance, Policy,… more
- Humana (Boston, MA)
- …deliver quality and value in a fast-paced, dynamic environment to support our Medicaid program through engaging in the transformation of clinical data to inform ... make an impact** **Responsibilities:** + Become an expert in HEDIS and Medicaid specifications, processes, and schedules + Partner to develop comprehensive … more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Medicaid Actuary role is responsible for providing actuarial support for multiple states in ... are the specific day to day responsibilities of the Medicaid Actuary role: + Frequent analysis of actual experience...of technical experience + 2 or more years of project leadership experience **Scheduled Weekly Hours** 40 **Pay Range**… more
- Humana (Boston, MA)
- …our caring community and help us put health first** Humana is seeking a Senior Project Manager to join our growing team. The Senior Project Manager manages all ... to finish, and works to drive on-time and on-budget projects. The Senior Project Manager works on problems of diverse scope and complexity ranging from moderate… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Associate VP, Data Science uses mathematics, statistics, machine learning, business analysis, and ... volumes of complex data into advanced analytic solutions. The Associate VP, Data Science requires an in-depth understanding of...be very selective about which projects the team pursues. Project selection needs to be a combination of inside-out… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Associate Director, Process Improvement - Telesales Stars Program position analyzes, and measures the ... develops sustainable, repeatable and quantifiable business process improvements. The Associate Director, Process Improvement requires a solid understanding of how… more
- Harvard University (Cambridge, MA)
- Details Title Research Associate /Data Analyst School Harvard School of Dental Medicine Department/Area Oral Health Policy and Epidemiology Position Description We ... The person will be responsible for completion of these tasks within project timelines and must ensure the integrity of data collection, review, compilation,… more
- Commonwealth Care Alliance (Boston, MA)
- …maintenance and enhancement of an effective Compliance Risk Assessment Program + Project manage regulator and other external reviews as assigned + Contribute towards ... impact on the Annual Internal Audit Plan or Annual Compliance Monitoring Plan. ** Project manage regulator and other external reviews as assigned** + Lead the… more
- Harvard University (Cambridge, MA)
- Details Title Research Associate /Data Analyst School Harvard School of Dental Medicine Department/Area Oral Health Policy and Epidemiology Position Description We ... will be responsible for successful completion of these tasks within competing project timelines, and must ensure integrity of data collection, data review, data… more
- Highmark Health (Boston, MA)
- …underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change management ... the most complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate high-level… more
- WellSense (Boston, MA)
- …across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, ... lead for the WellSense ACO and MCO programs under the Massachusetts Medicaid product known as MassHealth. WellSense's MassHealth enrollment includes >500k lives… more
- Humana (Boston, MA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid , or other Medical management organizations, hospitals/ Integrated Delivery Systems, ... medical management review organization, such as Medicare Advantage and managed Medicaid + Physical Medicine and Rehabilitation, Internal Medicine, Family Practice,… more
- Humana (Boston, MA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Boston, MA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Humana (Boston, MA)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- CenterWell (Boston, MA)
- …on moderately complex to complex issues regarding the technical approach for project components and work without direction. The Senior Healthcare Risk Professional ... senior management, or regulatory agencies as required. + Ensures that project /department milestones/goals are met. + Contributes to annual and longer-range… more
- Humana (Boston, MA)
- …+ Master's Degree or higher in Computer Science or a related field + Associate or Professional level solution architecture certification in Azure, GCP and/or AWS. + ... in Enterprise Architecture repository tools like iServer + 2+ years of project leadership and consulting experience. + Health Care Business Domains - Medicare,… more
- Commonwealth Care Alliance (Boston, MA)
- …standards, and due diligence, enterprise security and privacy policies, business associate agreements and business associate oversight, and corporate record ... **Desired Education (nice to have):** + Six Sigma Certification + Project Management Certification + Certification in Healthcare Compliance (CHC) **Required… more