- CVS Health (Boston, MA)
- …updates and data audits, production, and inventory management within the Medicaid Provider Data Service business organization. **Required Qualifications** + ... Microsoft Office Suite. **Preferred Qualifications** + Demonstrates mastery of Medicaid Provider Data Services job responsibilities and...position to succeed and meet expectations + Able to provide guidance to team and drive decisions based on… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, and ... deficiency reporting. The Senior Data Manager work assignments involve moderately...value in a fast-paced, dynamic environment to support our Medicaid program through engaging in the transformation of clinical… more
- Humana (Boston, MA)
- …Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing ... Engineer will be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities. They will… more
- Fallon Health (Worcester, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... With general direction from the Director of Quality, the Senior Program Manager ensures that the health... Medicaid Services (CMS), the Massachusetts Division of Medicaid (MassHealth) or Senior Care Options (Navicare).… more
- WellSense (Boston, MA)
- Senior Contract Manager -$5000 sign on bonus** WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New ... Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical...on bonus upon acceptance of offer **Job Summary:** The Senior Contract Manager is responsible for the… more
- Cardinal Health (Boston, MA)
- …can get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through ... manner. + Process enrollments via inbound fax, phone, and electronically. + Provide world-class service and receive inbound calls from patients, healthcare … more
- Abbott (Boston, MA)
- …way patients and professionals measure, track and analyze glucose levels. As a Senior Strategic Account Manager , responsibilities entail securing access for the ... types: Health Plans, Managed Care Organizations, Employer Groups, managed Medicaid , FFS Medicaid and Medicare plans within...**Learn more about our health and wellness benefits, which provide the security to help you and your family… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- ** Senior Project Manager ** **Category:** Business Consulting, Strategy and Digital Transformation **Main location:** United States, Massachusetts, Canton ... **Employment Type:** Full Time **Position Description:** The ePMO Program/Project Manager works with the Executive/Business sponsor to successfully implement new… more
- Elevance Health (Smithfield, RI)
- **Audit & Reimbursement Senior ** _Location: This is a United States based, virtual position._ **_National Government Services_** _is a proud member of Elevance ... contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs._ The **Audit and Reimbursement … more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Manager , Encounter Data Management develops business processes to ensure successful submission and ... reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and… more
- Prime Therapeutics (Boston, MA)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
- Elevance Health (Woburn, MA)
- … Medicaid Services to transform federal health programs. The ** Senior Enterprise Solutions Architect** creates architectural solutions that articulate the ... ** Senior Enterprise Solutions Architect** **Location:** This position will...or any combination of education and experience, which would provide an equivalent background. + This position is part… more
- MSys Inc. (Quincy, MA)
- …results. Must Haves: + Senior level resource + Previous Claims and Provider experience + Medicaid experience + Healthcare background + Worked in Hospital ... project Hybird Locals to MA only Description: The Business Analyst (BA) Project Manager lead will work on our established Provider Reimbursement Claims… more
- Insight Global (Woonsocket, RI)
- Job Description Insight Global is looking for a senior level Technical Program Manager with expereince in the automation space to help confiure a benefits ... presence experience working hand in hand with the SVPs Medicare, Medicaid , health insurance background experience Heavy Technical Program Management experience 10+… more
- CVS Health (Boston, MA)
- …more personal, convenient and affordable. **Position Summary** Aetna is recruiting for a Senior Manager , National Value Based Care (VBC) Development who will ... support innovative and strategic provider relationships as part of the VBC Business Development...strategies across multiple lines of business, including Medicare Advantage, Medicaid , ACA, and Commercial. + Develops relationships with providers… more
- Dana-Farber Cancer Institute (Boston, MA)
- …be available to assist and guide staff with challenging patients/families and to provide guidance in utilizing other Institute resources (eg, the Division of Social ... create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all...Works closely with the P/FR Director, and other P/FR senior staff, along with clinical and operational leaders to… more
- US Tech Solutions (Canton, MA)
- …benefit coverage for multiple products / lines of business; such as state specific Medicaid and Senior Products (Medicare Advantage and SCO). + The Clinical ... works under the general direction of the Precertification Team Manager or department Manager . The Clinical Reviewer...other external customers (agents acting on behalf of the provider or member or both) regarding the rational for… more
- Brockton Hospital (West Bridgewater, MA)
- …of our patients. Position Summary: Under the general supervision of the Ambulatory Coding Manager , and the Senior Risk Coder, the primary function of this ... Signature Healthcare is Southeastern Massachusetts' premier local provider of quality, personalized medical services. We are comprised of the award-winning… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …activities to prevent illegal, unethical, or improper conduct. + In conjunction with senior staff, respond to external audits, including Medicaid and Medicare ... down barriers, including systemic racism which harms us all. We provide community-based health care services that are compassionate, dignified, and culturally… more
- Humana (Boston, MA)
- …to meet customer needs and achieve our business success outcomes. + Provide strategic thought-leadership inside this organization, and with partner organizations in ... on approaches to best-practices in Product Management. Be a senior leader in how Product Management at the company...is backed by data and consumer needs. The Product Manager will also create the strategic plan that is… more