- Abt Global Inc. (Cambridge, MA)
- …seeks to add a talented researcher to its team of experts conducting policy-relevant Medicare and Medicaid research and evaluation. The successful candidate ... key technical roles on projects for the Centers for Medicare and Medicaid Services (CMS). As a...Medicaid Services (CMS). As a member of the Research , Monitoring, and Evaluation Capability, you will collaborate on… more
- Abt Global Inc. (Cambridge, MA)
- … research expert with demonstrated success directing projects funded by the Centers for Medicare and Medicaid Services (CMS). As a member of the Research , ... Opportunity** Abt Global seeks to expand its health care research team with the addition of a health care...a project director or equivalent for projects focused on Medicare policy. + Contribute subject matter expertise in the… more
- Prime Therapeutics (Boston, MA)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The … more
- Humana (Boston, MA)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... our caring community and help us put health first** The MarketPoint Senior Compliance Professional ensures compliance with governmental requirements. The Senior … more
- Humana (Boston, MA)
- …benefits organizations in the country. The Healthcare Strategy team supports Humana's Medicare and Medicaid business unit. This business unit, Humana's largest, ... total revenue and earnings. Team members partner with the senior leaders of the business unit, and more broadly...leveraging core consulting skills to support delivering some of Medicare and Medicaid 's highest priority projects and… more
- Humana (Boston, MA)
- …delivering high priority projects and initiatives across our insurance products (including Medicare , Medicaid , Med Supp, PDP, and others), with an emphasis ... total revenue and earnings. Team members partner with the senior leaders of the business unit, and more broadly...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Humana (Boston, MA)
- …in the country. **Location:** remote The Insurance Strategy team supports Humana's Medicare and Medicaid lines of business. This business unit, Humana's ... total revenue and earnings. Team members partner with the senior leaders of the business unit, and more broadly...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Mathematica (Boston, MA)
- …Agile methodology. * Conceptual and practical knowledge of health data (eg commercial, Medicare , Medicaid , or APCD claims data; EHR and/or HIE data; healthcare ... sources such as EHRs and HIEs, to effectively answer research questions about health care policy. * Incorporate client...some of our largest clients, including the Centers for Medicaid & Medicare Services (CMS) and other… more
- Humana (Boston, MA)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Senior Product Designer partners with specialty product teams to design specialty products that… more
- Evolent (Boston, MA)
- …in on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... for utilization management while working in conjunction with the Senior Medical Director. **Qualifications - Required and Preferred:** +...by any state or federal health care program, including Medicare or Medicaid , and is not identified… more
- Evolent (Boston, MA)
- …is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... exclusion or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by the Office of… more
- Dana-Farber Cancer Institute (Boston, MA)
- …Commission on Accreditation of Healthcare Organizations and the Center for Medicare and Medicaid Services' Conditions of Participation regulations regarding ... is a leader in life changing breakthroughs in cancer research and patient care. We are united in our...Works closely with the P/FR Director, and other P/FR senior staff, along with clinical and operational leaders to… more
- Prime Therapeutics (Boston, MA)
- …a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be ... Analyst (Regulatory Intelligence and Assessment) - Remote **Job Description** The Senior Compliance Analyst assists in the implementation of Prime's compliance… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Joint Commission (TJC), Department of Public Health (DPH), and the Centers for Medicare and Medicaid Services (CMS). This includes understanding and monitoring ... Reporting to the Senior Director, Quality Assurance and Regulatory Compliance, the...is a leader in life changing breakthroughs in cancer research and patient care. We are united in our… more
- Mathematica (Boston, MA)
- …Staff in our Health unit will eventually work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on CMS contracts will ... or remotely.* The HCLS business development team focuses on expanding Mathematica's research , digital, data, and advisory services offerings with clients across the… more
- State of Massachusetts (Boston, MA)
- …to, The Joint Commission on Accreditation of Healthcare Organizations (TJC), Centers for Medicaid and Medicare Services (CMS), Department of Public Health (DPH), ... CQO is accountable to lead, support and guide the Senior Leadership team in matters related to regulatory requirements,...and interpret same to facility wide personnel. * Exceptional research and presentation skills with a talent for engaging… more
- Humana (Boston, MA)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... and Reporting: Monitor sustainability metrics and develop reports for senior leaders outlining the effectiveness of sustainability initiatives. ADD: Oversight… more
- Cardinal Health (Boston, MA)
- …concurrent assignments and work with a sense of urgency + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, preferred ... specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers. Individualized… more
- State of Massachusetts (Boston, MA)
- …Health Information Management Department to ensure ongoing compliance with Center for Medicare and Medicaid Services (CMS) Conditions of Participation (COP) and ... quarterly medical record audit process. Develops corrective actions with appropriate senior managers and clinicians to promote and ensure compliance. * Ensures… more
- Cardinal Health (Boston, MA)
- …benefit investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and ... and expertise in the areas of advice and consulting, research and patient care to internal business units and...instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **_Responsibilities_** The… more