- 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 Humana's services using technology and analytics. We are looking for a Senior Data Scientist who will utilize cutting-edge AI, NLP, GenAI techniques, build… 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 our caring community and help us put health first** The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs… 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. ... 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
- 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
- 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. ... analytic product development, and cutting-edge data science capabilities. The Senior **Workday** Business Intelligence Engineer describes the tools, technologies,… more
- State of Massachusetts (Tewksbury, MA)
- …the high level of services required by The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), and other regulatory and oversight agencies. ... COO serves as a member of the Leadership and Senior Management Teams and will take the lead role...status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons… 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. ... improve quality and the member experience + Works with senior executives and various program owners to develop and...the requisition number so we may be able to research your request quicker. \#LI-LM1 **Scheduled Weekly Hours** 40… more
- Evolent (Boston, MA)
- …exclusions, sanctions, or disciplinary actions by **state or federal healthcare programs ( Medicare , Medicaid , OIG, or GSA).** Join us at **Evolent Health** ... Collaborate with cross-functional teams, including **clinical reviewers, management, and senior leadership,** to improve decision-making and care outcomes. + Assist… more