- Commonwealth Care Alliance (Boston, MA)
- …ongoing evaluation of the appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a wide range of ... and demonstrated capabilities. The position will report to the LTSS Program Manager. Reporting to the Manager,...and (e)assistance to these external partners as necessary. The Specialist is expected to work with managers and staff… more
- Commonwealth Care Alliance (Boston, MA)
- …Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening relationships with ... diverse provider community - including physician, hospital, behavioral health, community-based, LTSS , and HCBS providers. This individual serves as a key liaison,… more
- Commonwealth Care Alliance (Boston, MA)
- …provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including ... primary care practices, specialists, physician organizations, hospitals, ancillary and LTSS providers. Key responsibilities include establishing positive working relationships… more
- Commonwealth Care Alliance (Boston, MA)
- …the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical review and authorization creation ... Medicare Part B medications, long term services and supports ( LTSS ), and home health (HH). * Maintains and optimizes...Lead preparation for internal and external audits (eg CMS Program Audits, or EQRO reviews). * Hire, train and… more
- Molina Healthcare (Boston, MA)
- …of services for members including behavioral health, long-term services and supports ( LTSS ), and home and community resources to enhance continuity of care. * ... (LCSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical… more