- Point32Health (Canton, MA)
- …perform in the position. + Accounting, finance, or banking experience is preferred, managed health care operations experience is a plus **SKILL REQUIREMENTS:** ... a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are… more
- Point32Health (Canton, MA)
- …with presenting findings in a team environment. + Strong understanding of the managed care industry, preferably Medicare Advantage plans. + Experience in Product ... regulatory requirements and timelines. The Senior Manager works closely with claims , membership operations, clinical services, care management, customer… more
- Humana (Boston, MA)
- …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
- HealthEdge Software Inc (Boston, MA)
- …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …** Vendor Management** + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless ... up-to-date, compliant information is provided to patients and Health Care Providers while the risk of write- offs is...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Takeda Pharmaceuticals (Boston, MA)
- … Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more