- Commonwealth Care Alliance (Boston, MA)
- …access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider ... organizational performance. By fostering strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital… more
- Commonwealth Care Alliance (Boston, MA)
- …and retention. - Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational ... and grievances to identify root causes, recommend process improvements, and enhance provider satisfaction and performance. - Partner with senior leaders to… more
- FM (Johnston, RI)
- …subsidiaries (FM) with contracts, inclusive of non-disclosure agreements (excludes Claims and litigation based non-disclosure agreements). Responsibilities extend to ... The Corporate Affairs Contracts Specialist II supports the Corporate Affairs Contracts Manager , Corporate Affairs Counsel, the Manager , Corporate Affairs, and… more
- CVS Health (Boston, MA)
- …strategic initiatives, and partnering to elevate insights that can positively impact provider experience. The Senior Manager , accounts receivable ... to help review, understand, and identify process improvements across key provider journeys including self-service / digital transactions, claims management,… more
- Zurich NA (Boston, MA)
- …**This role will be filled at either the** ** Senior or AVP Claims Professional** **Level.** **The hiring manager will determine the appropriate level based ... + Microsoft Office experience + Knowledge of insurance regulations, markets, and products OR Senior Claims Professional: + Bachelor's Degree and 6 or more years… more
- Elevance Health (Boston, MA)
- …combination of education and experience which would provide an equivalent background. + ** Claims Auditor Senior :** Requires a HS diploma or GED and a ... ** Claims Auditor I, II and Senior **...or any combination of education and experience which would provide an equivalent background. + ** Claims Auditor… more
- Children's Hospital Boston (Boston, MA)
- 82448BRJob Posting Title:IT Epic Manager (Hospital Billing and Claims )Department:IT MOSAIC ProjectAutoReqId:82448BRStatus:Full-TimeStandard Hours per Week:40 Job ... platform consolidating two systems into Epic. The IT Epic Manager for Hospital Billing and Claims will...and assignments of team members to meet business needs. Provide input into department goals. Ensure the team has… more
- CVS Health (Boston, MA)
- …to solution design and architecture discussions, collaborating with architects and senior engineers. + Provide input on technical feasibility, performance ... project work that crosses many Aetna Technology domains/applications. A Release Manager in this area requires substantial business and systems knowledge along… more
- WelbeHealth (Boston, MA)
- … claims with errors back to the claims team for corrections + Provide feedback to the Oversight & Monitoring Manager on claims processing errors, ... senior care by providing an all-inclusive healthcare option (PACE) to the most vulnerable senior population while serving as a care provider and care plan to… more
- WelbeHealth (Boston, MA)
- … senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, while serving as a care provider and care plan to those ... pivotal role in ensuring timely and efficient processing of claims for our contracted specialty provider partners....procedures, or other established quality standards + Work alongside manager to establish and maintain claims processing… more
- Point32Health (Canton, MA)
- …(https://www.point32health.org/) . **Job Summary** Working under the direction of the Director or Senior Manager , the Senior Network Performance Analyst will ... on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around… more
- State of Massachusetts (Boston, MA)
- …do:* Lead Claims Examiner/Job Service Representative II, who reports to the Senior Manager of Benefit Operations & Program Integrity is based in Boston, ... *Lead Claims Examiner/Job Service Representative II| Department of Family...process to ensure that appropriate internal procedures were followed. Provide technical assistance and guidance to Job Service-Representative I's… more
- Pfizer (Cambridge, MA)
- …to support business-critical decisions for Adcetris and Elrexfio. The Senior Manager will manage various data assets, including claims , sales, and specialty ... The Senior Manager of Data Science &...Data Analysis** : Leverage multiple external data sources (eg, claims data, specialty pharmacy data, non-retail sales) to generate… more
- Commonwealth Care Alliance (Boston, MA)
- …and retention. * Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational ... and grievances to identify root causes, recommend process improvements, and enhance provider satisfaction and performance. * Partner with senior leaders to… more
- Danaher Corporation (Boston, MA)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position is a provider / customer ... responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of...this role, you will have the opportunity to: + Provide education to healthcare providers, lab professionals, office staff… more
- RxBenefits (Boston, MA)
- In this multi-disciplinary, cross functional role, the Senior Manager , Pharmacy Pricing will report to the Director, Pharmacy Pricing & Analytics. The Senior ... file requests, current account RFPs, and competing PBM comparisons. The Manager also assists with resolving client issues involving performance discrepancies and… more
- WSP USA (Boston, MA)
- This Opportunity WSP is currently recruiting a full time ** Senior Project Manager ** to join our Property & Buildings team in **Boston.** The ideal candidate will ... Management of client and subconsultant invoicing. + Review contract claims and advise senior management. + Grow...in a dynamic work environment. + Works independently to provide guidance and leadership to mid-level to senior… more
- Fallon Health (Plymouth, MA)
- …health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program ... (depending upon product and circumstance) relationships with the member/caregiver(s) and provider partners to better ensure ongoing service provision and care… more
- Walgreens (Rockland, MA)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Dana-Farber Cancer Institute (Boston, MA)
- … Business Intelligence Analyst. In partnership with Business Strategy, the Senior Business Intelligence Analyst builds claims -based analytical models, integrates ... and process improvement. Ongoing projects encompass market analyses from claims , referral tracking, and performance measurement for strategic initiatives, all… more
