- Commonwealth Care Alliance (Boston, MA)
- …compliance requirements. + Maintain a solid understanding of Medicare and Medicaid reimbursement methodologies for assigned services. + Conduct on-going ... and health care financing required. + Solid understanding of Medicare and Medicaid reimbursement methodologies and particular expertise in Medicare and … more
- Commonwealth Care Alliance (Boston, MA)
- …teams to monitor network performance against internal and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA ... 011230 CA- Provider Engagement & Performance Position Summary: The Director...contracting, or population health initiatives. - Prior work with hospital systems, large medical groups, and specialty care networks.… more
- Commonwealth Care Alliance (Boston, MA)
- …and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital , behavioral health, ... Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/ Medicaid ) + Experience in health plan provider relations + Experience… more
- Somatus (Nashua, NH)
- …country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious ... of 3 weeks' Vacation (PTO) + Professional Development, CEU, and Tuition Reimbursement + Curated Wellness Benefits supporting teammates physical and mental well-being… more
- Humana (Boston, MA)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Commonwealth Care Alliance (Boston, MA)
- …teams to monitor network performance against internal and regulatory benchmarks. * Ensure provider network compliance with CMS, state Medicaid agency, and NCQA ... 011230 CA- Provider Engagement & Performance Position Summary: The Director...contracting, or population health initiatives. * Prior work with hospital systems, large medical groups, and specialty care networks.… more
- Cognizant (Boston, MA)
- We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United ... Monday to Friday - Eastern Time **About the role:** As an AR Physician Hospital Billing Follow Up, you will be responsible for resolving aged hospital … more
- Cambridge Health Alliance (Cambridge, MA)
- …(ARC) or American Heart Association (AHA)BLS certification required + Experience: Hospital Care Management Experience strongly preferred. + Provider Minimum ... medical illness. Casework or therapy takes place in the hospital setting. Summary: Under the general supervision of the...and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case… more
- Molina Healthcare (Lowell, MA)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Chiesi (Boston, MA)
- …legislative changes. + Maintain a deep understanding of the distribution, hospital , specialty pharmacy channels; understand pharmacy and hospital capabilities ... and strong understanding with government programs, such as the IRA, 340B, State Medicaid , and Medicare Part D. + Relevant experience with distribution networks, new… more
