• Medicare Behavioral Health

    Fallon Health (Worcester, MA)
    …for member experience and service and clinical quality. **Brief Summary of Purpose:** The Behavioral Health Case Manager (BHCM) is responsible for assessing ... with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider...member's primary care physician, medical providers, behavioral health providers, state agencies and/or internal nurse case more
    Fallon Health (04/16/25)
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  • Behavioral Health Substance Use…

    Fenway Health (Boston, MA)
    Behavioral Health Substance Use Disorder Specialist Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Behavioral Health ... Under the general supervision of the Manager of Integrated Behavioral Health Services, the Behavioral ...+ Develops and maintains resource listings appropriate for Fenway Health patients + Works with Medicaid, Medicare ,… more
    Fenway Health (05/31/25)
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  • Behavioral Health Clinician - 55+…

    Fallon Health (Leominster, MA)
    Medicare , Medicaid, and PACE- in the region. **Brief Summary of Purpose:** The Behavioral Health Clinician provides Behavioral Health services in ... caregivers and SE staff. **Responsibilities** **Primary Job Responsibilities:** * Provides behavioral health support to Summit participants as referred by… more
    Fallon Health (05/07/25)
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  • Senior Care Options Nurse Case Manager…

    Fallon Health (Milford, MA)
    …approves their care plan o Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric ... we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE...or her health needs, social needs or behavioral health needs o Collaborates with appropriate… more
    Fallon Health (05/16/25)
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  • Senior Strategy Advancement Professional

    CenterWell (Boston, MA)
    …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... an in-depth understanding of the healthcare industry, including value-based care, Medicare , population health , Accountable Care Organizations (ACOs), medical… more
    CenterWell (06/24/25)
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  • Coding Auditor Educator

    Highmark Health (Boston, MA)
    **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine...works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs… more
    Highmark Health (05/09/25)
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  • CIC Advanced Practice Clinician

    Commonwealth Care Alliance (Boston, MA)
    …lead for medical care delivery and care coordination for the most complex medical and behavioral health patients. The APC functions within and is integral in a ... Plan Care Team members, Community Licensed Practical Nurses, Community Health Workers, Community Behavioral Health ...and CCA Leaders. * Identify and lead ad hoc case reviews with internal/external care team as needed. *… more
    Commonwealth Care Alliance (07/09/25)
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  • Manager, Healthcare Services (Remote…

    Molina Healthcare (Boston, MA)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... multidisciplinary integration and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Services & Supports for Molina… more
    Molina Healthcare (06/01/25)
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