- 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
- 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
- Beth Israel Lahey Health (Charlestown, MA)
- …(2) Produce data and analytics that deliver actionable business insights to BILH hospital , physician, and system leaders; (3) Provide strategic solutions that ... applying a deep knowledge of both government and commercial payment systems; and, (4) Provide Medicare, Medicaid , and payment system expertise in support of BILH… more
- Beth Israel Lahey Health (Westwood, MA)
- …difference in people's lives.** Under the direction of the Manager, Provider Enrollment completes enrollment and health plan recredentialing applications. Maintains ... resource to providers, practice staff, BIDCO staff and health plan provider representatives concerning health care plan participation and status. Demonstrates… more
- Cambridge Health Alliance (Everett, MA)
- …**Pay Range:** $41.58 - $93.96 per hour **Location:** CHA Everett Hospital **Work Days:** 8-4:30pm including weekend rotation **Category:** Registered Nurse ... medical illness. Casework or therapy takes place in the hospital setting. Under the general supervision of the Director...and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case… more
- Cambridge Health Alliance (Somerville, 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 (Boston, 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
- Fresenius Medical Center (Chelsea, MA)
- …2,600+ dialysis centers, 350+ research sites across North America + Largest provider of renal care products and services in the nation, including state-of-the-art ... renal specialty laboratories + Up to $5,200 RN tuition reimbursement per calendar year Great for Nursing Assistants ,...and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as… more
- Fresenius Medical Center (Roxbury, MA)
- …2,600+ dialysis centers, 350+ research sites across North America + Largest provider of renal care products and services in the nation, including state-of-the-art ... renal specialty laboratories + Up to $5,200 RN tuition reimbursement per calendar year Great for Nursing Assistants ,...and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as… more
- Cambridge Health Alliance (Somerville, MA)
- …(ARC) or American Heart Association (AHA)BLS certification required + Experience: Hospital Care Management Experience strongly preferred. + Provider Minimum ... of effective and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case Manager will collaborate… 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
