- Evolent (Boston, MA)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Clinical Rules Management , Analyst ** Seeking a detail-oriented ** ... Clinical Rules Management , Analyst ** who will play a critical role in ensuring the accuracy and integrity of our clinical rule engine, impacting our … more
- Highmark Health (Boston, MA)
- …job works collaboratively riskacross Highmark Health clinical areas to support clinical quality auditing, The Senior Risk Compliance Analyst is responsible ... subject matter expert, providing insights and guidance to internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …remote with the ocassional time onsite as needed.** The Sr. Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed ... be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies...in an academic medical center + Experience working in clinical trials management system (CTMS) + CPT/DRG… more
- Intermountain Health (Boston, MA)
- **Job Description:** The RCO Rev Integrity Chargemaster Analyst II independently handles EPIC build, maintenance, and implementation of charge codes, fee schedules, ... and mentor teammates, provide education and guidance to revenue cycle and clinical teams, and assists with testing and validation. Supports and collaborates with… more
- Intermountain Health (Boston, MA)
- …the patient's account within Intermountain's policies and procedures. **Revenue Integrity Analyst II** 1.Analyze data, develop reports, review trends, and recommend ... site teams, external business partners/vendors, compliance, legal counsel, health information management , and designated areas in the response process. 5. Assists… more
- Cardinal Health (Boston, MA)
- … team to onboard new practices including Assessment Call and giving direction to Clinical Analyst owning account * Once the Rheum team grows, manage the ... training and oversite of all new Clinical Analyst Team members (working with HR,...Specialty Network requirements of the Provider Solutions, Customer Success, management , and HR Handbook rules * Assist… more
- Commonwealth Care Alliance (Boston, MA)
- …Integrity and Analytics + Direct and relevant experience with HCFA/UB-04 claims management , coding rules and guidelines, and evaluating/analyzing claim outcome ... Term **Position Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst … more
- CenterWell (Boston, MA)
- …Senior Strategy Advancement Professional will bring a combination of operational support, analyst skills, and strategy oversight to the role. This individual will ... Medicare, population health, Accountable Care Organizations (ACOs), medical group management / practice management , health plans /...necessary / required actions initiated by CMS * Oversee rules and regulations of ACO programs as outlined in… more
- Wolters Kluwer (Waltham, MA)
- …partners to define needs and deliver innovative solutions that support Clinical Effectiveness transformation initiatives. As a Business Transformation Architect, you ... processes and process flows, information and information flows, and business rules + Identify and leverage appropriate technology and applications to quantifiably… more