- Cardinal Health (Boston, MA)
- ** Manager , Managed Care ** **What Managed Care contributes to Cardinal Health** Practice Operations Management oversees the business and ... administrative operations of a medical practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal… more
- Beth Israel Lahey Health (Boston, MA)
- …not just taking a job, you're making a difference in people's lives.** The Managed Care Coordinator will support the ObGyn Department at Beth Israel Deaconess ... Medical Center in Boston, MA. The Managed Care Coordinator role is a hybrid...instructions and procedures as provided. Work is monitored by supervisor/ manager . + **Written Communications:** Ability to communicate clearly and… more
- Deloitte (Boston, MA)
- ServiceNow Senior Manager - Consulting Managed Services Enterprise Operations as a Service provides multi-year managed service contracts to support ... is where ambition meets opportunity. As a Deloitte Senior Manager , you will have the opportunity to lead and...experience in either: Consumer, Financial Services, Life Sciences Health Care , Technology Media and Telecom, Energy Resources and… more
- Atrius Health (Newton, MA)
- …welfare benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** *Senior Managed Care Analyst* **Location:** *Newton MA - ... Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients at 30 medical… more
- Commonwealth Care Alliance (Boston, MA)
- …Master's Degree preferred Required Experience: + 5-7 years + Experience working in a health care or managed care setting with specific background in contract ... negotiations and management. + Specific background in complex managed care provider contracting including Health Systems, Physician Hospital Organizations,… more
- Molina Healthcare (Brockton, MA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Molina Healthcare (Mattapan, MA)
- …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
- Gentiva (Auburndale, MA)
- …excellence with strategic oversight? If so, you could be the next Hospice Patient Care Manager Senior on our team. At Gentiva Hospice, we're dedicated to ... live with dignity and comfort. As a Senior Patient Care Manager , you'll help guide branch-level clinical...Medicaid, JCAHO, ACHC), and best practices * Familiarity with managed care principles and human resource guidelines… more
- Molina Healthcare (Boston, MA)
- …and cost-effective based on the severity of illness and the site of service. The Care Manager , LTSS provides support for care management/ care ... consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex...care , including at least 1 year experience in care management, managed care , and/or… more
- Commonwealth Care Alliance (Boston, MA)
- …management Desired Experience (nice to have): * Experience working with managed care organizations, value-based programs, or community-based behavioral health ... care for members. In this role, the Program Manager acts as an account manager , relationship...a seamless provider experience and consistent delivery of quality care . The BH Provider Engagement Program Manager … more
- Highmark Health (Boston, MA)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... specialization + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN… more
- Cambridge Health Alliance (Cambridge, MA)
- Social Work Care Manager LICSW- Primary Care ... for the most vulnerable patients is coordinated and managed to deliver on the three goals of the Triple ... Street **Work Days:** 8-4:30 **Category:** Social Work **Department:** Primary Care Complex Care Mgmt **Job Type:** Full time **Work Shift:** Day **Hours/Week:**… more
- Commonwealth Care Alliance (Boston, MA)
- …) **Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting + 2 or more years working in a clinical setting ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Athena Health Care Systems (Brockton, MA)
- …nurtured to allow you to grow within the company. As an RN Hospice Case Manager , you plan, organize, and direct hospice care . The professional nurse builds from ... facilitates the patient's efforts toward self-sufficiency and optional comfort care . + Acts as Case Manager when...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow… more
- Commonwealth Care Alliance (Boston, MA)
- …high-quality, coordinated care in alignment with the health plan's model of care and strategic objectives. The Manager will also oversee corporate and ... 011230 CA-Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and nurturing… more
- State of Massachusetts (Boston, MA)
- …collaboration with staff from the Health Care Access Bureau and Bureau of Managed Care to advise the Commissioner about issues that may impact future ... citizens. *_About the Role:_* The Director of Pharmacy Benefit Manager Oversight operating within the Health Care ...market that have implications in health insurance mandates and managed care practices. * Manage staff working… more
- Beth Israel Lahey Health (Boston, MA)
- …expenses on Medicare Cost Report including mgmt of time studies. Liaisons with managed care to optimize contracts. Represent heart transplant with internal and ... process with internal teams for creation of charges, billing workflows and managed care contracting. (essential) 4. Maintains knowledge of regulatory… more
- Humana (Boston, MA)
- …the (appropriate state) with no disciplinary action. + An active designation as a Certified Care Manager (CCM). If no active designation as a CCM at hire date, ... holistic approach for case management throughout the continuum of care . The case manager will offer guidance,...delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours**… more
- East Boston Neighborhood Health Center (Revere, MA)
- …one year of experience working with a geriatric population. Experience in a managed care setting highly preferred. SKILLS/ABILITIES: Must have the ability to ... patients and communities. Whether you're a nurse or physician providing direct care , a manager leading dedicated teams, or part of the essential support staff… more
- Molina Healthcare (Boston, MA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more