• Managed Care Contract Manager

    Baystate Health (Springfield, MA)
    …of the Managed Care Contract Manager include performing contract analysis, developing payer strategy, engaging in contract negotiations, ... of the Director of Managed Care, the Managed Care Contract Manager is responsible for the key...these align or differ from other payer contracts or industry standards. Analyze performance of contract more
    Baystate Health (05/25/24)
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  • Senior Contract Manager

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …with providers to develop incentives to reduce racial inequities in care. The Senior Contract Manager works closely with the Director of Network Contracting to ... quality incentive programs, as well as achieve unit cost trend targets. The Senior Contract Manager is the primary negotiator for an assigned portfolio of… more
    Blue Cross Blue Shield of Massachusetts (06/11/24)
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  • Sr. Manager , Medicaid Contract

    Sumitomo Pharma (Boston, MA)
    **Title: Sr. Manager , Medicaid Contract Administration** **Location: Remote/occasional onsite (if local to MA). Flexible work/life balance.** Sumitomo Pharma ... motivated, and experienced individual for the position of **Sr. Manager , Medicaid Contract Administration.** The Sr. ...of the life science industry specific to the Medicaid payer landscape. The decisions made in this position affect… more
    Sumitomo Pharma (05/09/24)
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  • Senior Healthcare Contract Negotiator

    LogixHealth (Bedford, MA)
    …Healthcare Contract Negotiator at LogixHealth, you will work closely with the Contract Manager and Director to provide cutting edge solutions that will ... contract implementation and claims processing + Trouble shoot and resolve contract implementation issues + Identify existing contracts up for renegotiation… more
    LogixHealth (06/15/24)
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  • Research Contract Specialist

    Beth Israel Lahey Health (Burlington, MA)
    …of the Manager of the Office of Sponsored Research, the Contracts Specialist works with investigators, sponsors and contract research organizations, and ... agreements in accordance with Lahey and BILH policies. The Contracts Specialist reviews and negotiates contract terms...contract to executed agreement. Works with the OSR Manager to maintain a database of turnaround times, analyze… more
    Beth Israel Lahey Health (05/30/24)
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  • Manager , Net Revenue

    Beth Israel Lahey Health (Charlestown, MA)
    …including but not limited to charge capture, charge description master maintenance, payer contract management, and billing compliance. * Estimates net patient ... job, you're making a difference in people's lives.** The Manager of Net Revenue will play a crucial role...financial reporting. * Ensure compliance with healthcare financial regulations, payer contracts , and accounting standards. * Stay… more
    Beth Israel Lahey Health (05/23/24)
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  • Physician Reimbursement Integrity Manager

    Children's Hospital Boston (Boston, MA)
    …Physician's Organization (PO) at Boston Children's Hospital. This Physician Reimbursement Integrity Manager will: + Analyze PO managed care contracts and ... proposed pricing strategy recommendations. + Monitor and value impact of Payer 's payment policies and provide guidance to adjust contracting reimbursement to… more
    Children's Hospital Boston (06/07/24)
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  • Engineering Manager

    HealthEdge Software Inc (Boston, MA)
    **Overview** **The Product:** With HealthRules Payer ,our integrated solutions suite includes the industry's leading, digital, next-generation claims administration ... do much, more more than just core administrative processing. That's why HealthRules Payer has been ranked number one its class among CAP Solutions. Besides… more
    HealthEdge Software Inc (06/18/24)
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  • Manager , Office of Sponsored Research

    Beth Israel Lahey Health (Burlington, MA)
    …lives.** Under the general supervision of the Director of Research Administration, the Manager of the Office of Sponsored Research (OSR) oversees the office at Lahey ... law and regulation pertaining to the administration of research grants and contracts . OSR supports clinical investigators, administrative leadership, and LHMC by: 1)… more
    Beth Israel Lahey Health (06/13/24)
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  • Financial Clearance Specialist - Neurology Maps…

    Beth Israel Lahey Health (Cambridge, MA)
    …patients with Kiosk check-in as needed. + Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results. ... waiting area, securing all confidential patient information. + Identifies payer medical necessity determination before services are rendered. Informs departments… more
    Beth Israel Lahey Health (06/11/24)
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  • Release Manager

    HealthEdge Software Inc (Boston, MA)
    …customerssimultaneously with efficiency and effectiveness. **The Product:** _With HealthRules Payer ,_ our integrated solutions suite includes the industry's leading, ... do much, more more than just core administrative processing. That's why HealthRules Payer has been ranked number one its class among CAP Solutions. Besides… more
    HealthEdge Software Inc (06/12/24)
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  • Revenue Cycle Denial Associate 2

    Beth Israel Lahey Health (Burlington, MA)
    …improvements related to orders and/or documentation and makes recommendations to Manager and/or the perspective departments with high volume/high dollar values. 3. ... denials. 7. Initiates corrected claims and appeals according to payer guidelines. 8. Responds to incoming payer ...Keeps informed of all federal, state and managed care contract regulations. 12. Acts as a mentor and provides… more
    Beth Israel Lahey Health (04/20/24)
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  • Massachusetts and Rhode Island Market Medical…

    Commonwealth Care Alliance (Boston, MA)
    …programs. 3) In collaboration with their supervisor and Market General Manager , works with external stakeholders including network providers and facilities to ... care delivery, metrics, outcomes, and accurate HCC coding for value-based contracts . Identifies cost drivers and works with network providers on management… more
    Commonwealth Care Alliance (05/30/24)
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  • Patient Access Representative - Part-time, 24…

    Beth Israel Lahey Health (Newburyport, MA)
    …patients with Kiosk check-in as needed. 3. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results. ... and accuracy levels and communicates regularly with the Supervisor and Manager . **Pre-Registration:** 17. Efficiently registers patients, capturing and verifying all… more
    Beth Israel Lahey Health (06/19/24)
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  • Patient Access Representative - Urology

    Beth Israel Lahey Health (Cambridge, MA)
    …patients with Kiosk check-in as needed. + Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results. ... and accuracy levels and communicates regularly with the Supervisor and Manager . + Efficiently registers patients, capturing and verifying all required information… more
    Beth Israel Lahey Health (06/14/24)
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  • Patient Access Representative

    Beth Israel Lahey Health (Plymouth, MA)
    …cash drawer at end of each business day. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results. ... accuracy levels and communicates regularly with the Supervisor and Manager . **Pre-Registration:** Efficiently registers patients, capturing and verifying all… more
    Beth Israel Lahey Health (06/14/24)
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  • LMHC/LICSW - Partial Hospitalization Assistant…

    Universal Health Services (Fall River, MA)
    …that clinical services are in full compliance with applicable regulations and payer contract specifications. This role delivers direct services to clients, ... or LMHC required + Minimum of two years as a clinical supervisor or program manager preferred + Prior experience with children & adolescents as well as a higher… more
    Universal Health Services (06/07/24)
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  • Partial Hospitalization Director (PHP)…

    Universal Health Services (Fall River, MA)
    …that all clinical services are in full compliance with applicable regulations and payer contract specifications. This Director will promote the development of ... or LMHC required + Minimum of two years as a clinical supervisor or program manager preferred + Minimum of five years of psych experience preferably in a community… more
    Universal Health Services (06/06/24)
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  • Patient Access Rep. F/T Evenings (3p-11:30 pm) -ED…

    Beth Israel Lahey Health (Burlington, MA)
    …patients with Kiosk check-in as needed. 3. Completes the Medicare Secondary Payer Questionnaire for each patient and adjusts patient coverage based on results. ... and accuracy levels and communicates regularly with the Supervisor and Manager . **Pre-Registration:** 17. Efficiently registers patients, capturing and verifying all… more
    Beth Israel Lahey Health (04/30/24)
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