- 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)
- …a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy ... Organization to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to… more
- Humana (Boston, MA)
- …SC Medicaid market populations. + May provide cross-coverage for other state Medicaid markets, as well as participate on project teams or organizational ... The Medical Director reports to the Lead Medical Director for the Southeast Medicaid Markets. In this role, the Medical Director actively uses a medical background,… 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)
- …a part of our caring community and help us put health first** The Associate Actuary role is a role within the Insurance Products Actuarial Medicare Advantage ... ad hoc projects and analysis to help enhance Part D accuracy. The Associate Actuary, Pricing work assignments involve moderately complex to complex issues where the… 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)
- …a part of our caring community and help us put health first** The Associate VP, IT Portfolio Management collaborates with the business portfolio team to align the ... IT portfolio and demand. The Associate VP, IT Portfolio Management requires a in-depth understanding...large scale, highly visible programs with responsibility for multiple project teams **Scheduled Weekly Hours** 40 **Pay Range** 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 ... 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
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Medicaid Long-Term Supports and Services (LTSS) Process Improvement Lead analyzes and measures the ... diverse scope and complexity ranging from moderate to substantial. The LTSS Medicaid Process Improvement Lead researches best business practices within and outside… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy ... clients. We are a diverse set of highly skilled individuals with deep Medicaid subject matter expertise working in an agile, collaborative environment. To achieve… 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)
- …Support (LTSS)/Long Term Care (LTC) providers for the Illinois Medicare - Medicaid Alignment Initiative (MMAI) plan. The Senior Market Development Professional work ... decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. **Use your skills to… 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
- Humana (Boston, MA)
- …+ Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if there are concerns ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees… more