- Humana (Boston, MA)
- …in genetics ortho or general surgery preferable** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or Commercial ... and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements,...of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise… more
- Commonwealth Care Alliance (Boston, MA)
- …telephonic case management or primary care . + Experience with a Medicare Advantage population preferred. + Past experience caring for patients/members with ... services via telehealth technologies (video, chat, etc.) for clinically appropriate clinical care and care management services. **Working Conditions:** + … more
- Humana (Boston, MA)
- …(such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand… more
- Humana (Boston, MA)
- …such as inpatient rehabilitation. **Preferred Qualifications:** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid ... of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid...MD or DO degree + 5+ years of direct clinical patient care experience post residency or… more
- Evolent Health (Boston, MA)
- …for Evolent Primary Care and sub-plans for each business segment (MSSP, Medicare Advantage , and Commercial payer partnerships) + Sets clear goals and ... ECP launched as an internal start-up in 2020 with a wholly owned Medicare Shared Savings Program ("MSSP") Accountable Care Organization ("ACO") spanning four… more
- Commonwealth Care Alliance (Boston, MA)
- …& Abilities Required:** + **Market Prominence** Knowledge of MHK's Market Prominence Medicare Advantage Member Management Platform + **Agile Product Owner** ... Teams, Slack, etc) + Experience that solidified the candidate's strategic business, clinical and/or financial acumen and ability to contextualize work priorities +… more
- Humana (Boston, MA)
- …Stars team centralizes quality improvement and governance processes targeting Humana's Medicare Advantage members while also managing compliant data submissions ... Quality & Stars) is responsible for improving health outcomes and advancing the care experience of our members and provider partners. The Risk Adjustment team… more
- Brockton Hospital (Brockton, MA)
- …of Medicare and Medicaid programs, state insurance and health care laws, HITECH, HIPAA and general Corporate Compliance principles. Maintains up-to-date ... medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference...knowledge of health care legal requirements, and determines if policy revisions or… more
- Humana (Boston, MA)
- …relevant rational database programming language **Preferred Qualifications** + Experience with Medicare Advantage + Experience with member level claims ... insurance and many other opportunities. **About us** About CenterWell Senior Primary Care : CenterWell Senior Primary Care provides proactive, preventive care… more