- CVS Health (Boston, MA)
- …all with heart, each and every day. **Position Summary** + Lead a team of Medicaid Provider Data Services Analysts responsible for loading and maintaining ... Medicaid Provider data within Aetna QNXT. + Team...Medicaid Provider data within Aetna QNXT. + Team...or Network operations. + 1+ years of experience in Medicaid provider operations. + At least 1… more
- Fallon Health (Worcester, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... in core system accurately and timely. This is to be completed through review of data integrity reports, and working closely with Provider Partners, Provider … more
- Commonwealth Care Alliance (Boston, MA)
- …account manager , relationship manager , and performance partner - using data , provider feedback, and system collaboration to enhance provider ... Engagement & Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for...and Data Insight * Analyze and interpret provider data related to utilization, cost, quality,… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and ... executing communication strategies that foster strong, collaborative relationships with provider partners serving dual-eligible (Medicare- Medicaid ) members. This… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... and Systems (CAHPS), and social determinants of health (SDOH) measures. The Program Manager will work collaboratively with our provider network and Quality teams… more
- Humana (Boston, MA)
- …providers, with full accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...-friendly insights. + Lead the design and refinement of provider -facing data views (dashboards, insights, performance summaries)… more
- Commonwealth Care Alliance (Boston, MA)
- …systems, large medical groups, and specialty care networks. * Experience supporting provider data integrity, onboarding, and credentialing processes. * Proven ... and retention. * Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational… more
- Commonwealth Care Alliance (Boston, MA)
- …to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing ... provider engagement strategy, focused on delivering a best-in-class provider experience. + Utilize strategic planning and data -driven insights… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the ... as mid-year and annual reviews and program-wide performance summaries. * Support delegated provider staff in using data tools effectively and understanding … more
- CenterWell (Boston, MA)
- …part of our caring community and help us put health first** The Manager of Pre-Bill Audit provides strategic leadership and operational oversight for the ... improvements in unbilled rates, revenue cycle performance, and compliance. The Manager leads a team of Pre-Bill Specialists, partners with senior leadership,… more
- Fallon Health (Lowell, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a… more
- Humana (Boston, MA)
- …technical program management, including at least 3 years as a Technical Product Manager in data , AI/ML, or personalization platforms. + Demonstrated success in ... advanced agentic AI decision-making across our organization. As a Lead Technical Product Manager (PM-T), you will be responsible for shaping the vision, defining the… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice ... is true to the best of my knowledge. **Job Description** Join Takeda as the Manager of Price and Gross-to-Net (GTN) Forecasting within the US Business Unit. For this… more
- Cardinal Health (Boston, MA)
- …conducts investigations to resolve ethics and compliance issues. **Compliance Audit Manager ** Reporting to the Compliance Director, this position supervises and ... annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. **Responsibilities** +… more
- Humana (Boston, MA)
- …us put health first Humana's Product organization is seeking a Lead Product Manager to drive the strategy, development, and optimization of the Adobe Experience ... translating business needs into platform capabilities that enable personalized, data -driven customer experiences. You'll work closely with cross-functional teams to… more
- Humana (Boston, MA)
- …at the center of everything it does. We are seeking a Lead Product Manager to drive the vision, strategy, and execution of our Sales and Marketing Technology ... our sales and marketing teams to achieve growth targets. The Lead Product Manager Conceives of, develops, delivers, and manages products for customer use. The Lead… more
- US Tech Solutions (Malden, MA)
- …Stoneham, Wakefield and Winthrop MA area** Under the administrative direction of the Clinical Manager , the Nurse Case Manager (NCM) for Senior Care Options (SCO) ... individualized plan of care + Completion of the Minimum Data Set-Home Care (MDS-HC). Facilitation of member and caregiver...to resolve issues that may be barriers to care. Provide education and coaching to the member, family, and/or… more
- Riverside Community Care (Dedham, MA)
- Riverside Community Care Love what you do! Clinical Team Manager - BHCP Riverside is seeking a Clinical Team Manager for our Behavioral Health Community Partner ... supports. We help people to live in the community independently and provide appropriate treatment and recovery support for individuals with complex behavioral health… more
- Philips (Cambridge, MA)
- **Territory Manager - RespirTech (Baltimore, ME, Annapolis, ME, Wilmington, ME)** RespirTech's Territory Manager represents the InCourage airway clearance ... evidence to physicians. + Being an expert on Medicare, Medicaid and private insurance coverage-criteria for InCourage vest therapy,...in order for coverage to be obtained. + Analyzing data to effectively target priority healthcare teams and create… more
- Commonwealth Care Alliance (Boston, MA)
- …to include accurate ASAP, LTSC Agency, GSSC and LTSC, among other details o Coordinate Provider Rosters with the Provider Data Networks Team * Disseminate ... support o Link with CCA's Business Intelligence team and Provider Engagement Analytics Manager to request reports...Manager to request reports as needed o Perform data quality checks, and additional data review… more