- Commonwealth Care Alliance (Boston, MA)
- …teams to monitor network performance against internal and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA ... 011230 CA- Provider Engagement & Performance Position Summary: The Director...contracting, or population health initiatives. - Prior work with hospital systems, large medical groups, and specialty care networks.… more
- Commonwealth Care Alliance (Boston, MA)
- …and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital , behavioral health, ... Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/ Medicaid ) + Experience in health plan provider relations + Experience… more
- Humana (Boston, MA)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Commonwealth Care Alliance (Boston, MA)
- …teams to monitor network performance against internal and regulatory benchmarks. * Ensure provider network compliance with CMS, state Medicaid agency, and NCQA ... 011230 CA- Provider Engagement & Performance Position Summary: The Director...contracting, or population health initiatives. * Prior work with hospital systems, large medical groups, and specialty care networks.… more
- Beth Israel Lahey Health (Westwood, MA)
- …difference in people's lives.** Under the direction of the Manager, Provider Enrollment completes enrollment and health plan recredentialing applications. Maintains ... resource to providers, practice staff, BIDCO staff and health plan provider representatives concerning health care plan participation and status. Demonstrates… more
- Option Care Health (Boston, MA)
- **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Humana (Boston, MA)
- …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
- Hologic (Marlborough, MA)
- …in relationship development + Hands-on experience with Medicare Part B reimbursement , hospital outpatient departments and physician office-based reimbursement ... in the United States. This role will be instrumental in optimizing reimbursement pathways, expanding coverage, and ensuring access across various sites of care.… more
- Cambridge Health Alliance (Somerville, MA)
- …Healthcare Providers BLS (Basic Life Support) certification is required + Experience: Hospital Care Management Experience strongly preferred. + Provider Minimum ... medical illness. Casework or therapy takes place in the hospital setting. Summary: Under the general supervision of the...and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case… more
- Molina Healthcare (Boston, MA)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Epic and/or other comparable software and database tools. + Knowledge of hospital operations, reimbursement , and applicable regulatory requirements. + Ability to ... integrity, accuracy, and regulatory compliance of Dana-Farber Cancer Institute's hospital and professional billing through data-driven audits and targeted… more
- Fresenius Medical Center (Roxbury, MA)
- …2,600+ dialysis centers, 350+ research sites across North America + Largest provider of renal care products and services in the nation, including state-of-the-art ... renal specialty laboratories + Up to $5,200 RN tuition reimbursement per calendar year Great for Nursing Assistants ,...and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as… more
- Cambridge Health Alliance (Cambridge, MA)
- …10782 **Pay Range:** $41.58 - $93.96 per hour **Location** : CHA Cambridge Hospital **Work Days** : Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category** : ... medical illness. Casework or therapy takes place in the hospital setting. Cross Training to all areas of Care...and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case… more
- Cambridge Health Alliance (Everett, MA)
- …10687 **Pay Range:** $41.58 - $93.96 per hour **Location** : CHA Everett Hospital **Work Days** : Mon - Friday and Rotating Weekends/Holiday **Category** : ... medical illness. Casework or therapy takes place in the hospital setting. Cross Training to all areas of Care...and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case… more
