- Fallon Health (Worcester, MA)
- …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid , and PACE (Program of All-Inclusive Care for the ... all quality related obligations required by the Centers of Medicare and Medicaid Services (CMS), the Massachusetts... Medicaid Services (CMS), the Massachusetts Division of Medicaid (MassHealth) or Senior Care Options (Navicare).… 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. ... help us put health first** Humana Healthy Horizons in Oklahoma is seeking a Claims Research & Resolution Lead to lead a team that focuses on supporting providers in… 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)
- …help us put health first** Humana Healthcare Research (HHR), a health outcomes research subsidiary of Humana, is seeking a Senior Data Engineer to design, ... efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large.… 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. ... part of our caring community and help us put health first** The Senior Behavioral Economics Professional (SBEP) is a core member of Humana's industry-leading… 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. ... of healthcare through AI excellence. We are seeking a Senior Data Scientist to develop reliable, interpretable, and steerable...+ Master's Degree and 3+ years of experience in research /ML engineering or an applied research scientist… 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 Professional Provider Network Strategy will be accountable for supporting the development of… 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. ... first** The Associate Actuary, Analytics/Forecasting applies statistical/actuarial methods to advise senior leadership and other business stakeholders on matters of … more
- Humana (Boston, MA)
- …a managed care healthcare system or health plan. + Experience working in Medicaid and/or Medicare . **Preferred Qualifications** + 3+ years of leadership ... processes. + Proficiency in Microsoft Office programs. + Experience working in Medicaid / Medicare implementation. + Prosci, Six Sigma, and/or Project Management… 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. ... can be used to drive customer acquisition in the Medicare Advantage space. Within this business area, we are...on approaches to best-practices in Product Management. Be a senior leader in how Product Management at the company… 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. ... ideal candidate will possess a deep understanding of the Medicare landscape, strong analytical skills and the ability to...leadership team + Collaborate with Stars Measure Owners and senior leaders to refine strategies that align our mission,… 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)
- …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** + MD/DO/MBBS Degree + Current,...by any state or federal health care program, including Medicare or Medicaid , and is not identified… 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. ... product partners, and Integrated Health. + Guide and mentor UI, UX, research , and content professionals in best practices. + Foster collaboration between design… 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
- 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 (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
- 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. ... Strategy Lead, you will deconstruct issues and challenges, perform targeted research and analysis, and craft sound, logical solutions and recommendations. You… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …regulatory and licensure surveys by the Department of Public Health, Centers for Medicare and Medicaid Services and The Joint Commission. + Collaborates with ... is a leader in life changing breakthroughs in cancer research and patient care. We are united in our...QPS leadership, the Chief Quality Officer, and the Senior Director of Patient Safety to support the Quality… 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. ... infrastructure, innovative analytic product development, and cutting-edge data science capabilities. The Senior Data Scientist will be a key member of the People… more