- Commonwealth Care Alliance (Boston, MA)
- …account manager , relationship manager , and performance partner - using data , provider feedback, and system collaboration to enhance provider ... Engagement & Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for...and Data Insight - Analyze and interpret provider data related to utilization, cost, quality,… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... and Systems (CAHPS), and social determinants of health (SDOH) measures. The Program Manager will work collaboratively with our provider network and Quality teams… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and ... executing communication strategies that foster strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This… more
- Commonwealth Care Alliance (Boston, MA)
- …systems, large medical groups, and specialty care networks. - Experience supporting provider data integrity, onboarding, and credentialing processes. - Proven ... and retention. - Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational… more
- Commonwealth Care Alliance (Boston, MA)
- …to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing ... provider engagement strategy, focused on delivering a best-in-class provider experience. + Utilize strategic planning and data -driven insights… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the ... as mid-year and annual reviews and program-wide performance summaries. - Support delegated provider staff in using data tools effectively and understanding … more
- Commonwealth Care Alliance (Boston, MA)
- …to include accurate ASAP, LTSC Agency, GSSC and LTSC, among other details o Coordinate Provider Rosters with the Provider Data Networks Team - Disseminate ... support o Link with CCA's Business Intelligence team and Provider Engagement Analytics Manager to request reports...Manager to request reports as needed o Perform data quality checks, and additional data review… more
- CVS Health (Boston, MA)
- …all with heart, each and every day. **Position Summary** + Lead a team of Medicaid Provider Data Services Analysts responsible for loading and maintaining ... Medicaid Provider data within Aetna QNXT. + Team...Medicaid Provider data within Aetna QNXT. + Team...or Network operations. + 1+ years of experience in Medicaid provider operations. + At least 1… more
- Point32Health (Canton, MA)
- …engagement and consultation activities supporting the complete and accurate capture of risk adjustment data . To be successful, the Manager will need to rely on ... and programs (internal and vendor-driven) that optimize performance across our provider networks serving Point32Health's Medicare, Medicaid , Duals and Commercial… more
- Commonwealth Care Alliance (Boston, MA)
- …account manager , relationship manager , and performance partner - using data , provider feedback, and system collaboration to enhance provider ... Engagement & Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for...and Data Insight * Analyze and interpret provider data related to utilization, cost, quality,… more
- Humana (Providence, RI)
- …providers, with full accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...-friendly insights. + Lead the design and refinement of provider -facing data views (dashboards, insights, performance summaries)… more
- Commonwealth Care Alliance (Boston, MA)
- …systems, large medical groups, and specialty care networks. * Experience supporting provider data integrity, onboarding, and credentialing processes. * Proven ... and retention. * Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the ... as mid-year and annual reviews and program-wide performance summaries. * Support delegated provider staff in using data tools effectively and understanding … more
- CVS Health (Cumberland, RI)
- …cost-saving opportunities, and revenue growth strategies. + Ability to identify trends in data analysis and report key findings to manager + Prepare complex ... heart, each and every day. **Position Summary** As a Manager of Finance, you will be responsible for financial...and analysis within the Aetna Better Health of Virginia Medicaid health plan. This role will require strong time… more
- CenterWell (Providence, RI)
- …part of our caring community and help us put health first** The Manager of Pre-Bill Audit provides strategic leadership and operational oversight for the ... improvements in unbilled rates, revenue cycle performance, and compliance. The Manager leads a team of Pre-Bill Specialists, partners with senior leadership,… more
- Brockton Hospital (Brockton, MA)
- …risks, and areas for improvement in regulatory compliance and patient safety, the Manager utilizes data to inform decision-making and develop actionable insights ... Signature Healthcare is Southeastern Massachusetts' premier local provider of quality, personalized medical services. We are comprised of the award-winning… more
- Fallon Health (Boston, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a… more
- Point32Health (Canton, MA)
- …performance and competitors + Monitor product performance throughout the year and provide data -driven performance improvement recommendations across a variety of ... on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around… more
- CVS Health (Providence, RI)
- …of business systems, applications, and tools supporting network management, contracting, and provider data systems + Experience in related business environment ... audits out of QNXT and PRMS systems to support Medicaid SOC and SOX controls + Coordinate with applicable...with exposure to provider data , processes, etc. **Education** Bachelor's degree… more
- Humana (Providence, RI)
- …technical program management, including at least 3 years as a Technical Product Manager in data , AI/ML, or personalization platforms. + Demonstrated success in ... advanced agentic AI decision-making across our organization. As a Lead Technical Product Manager (PM-T), you will be responsible for shaping the vision, defining the… more
