- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health ... claims and preservice appeals. The Corporate Medical Director works on...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims and preservice appeals. The Corporate Medical Director works on...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Boston, MA)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Scientist supports analytic activities associated with BCBSMA overall performance on Medicare Stars ratings, with specific focus on CAHPS patient experience ... to help identify the most efficient means through which Medicare Stars clinical quality and patient experience performances at...into a cohesive view. Under direction of the Senior Director of Population Health Analytics, the Data Scientist will… more
- CVS Health (Boston, MA)
- …We are looking for a Principal Data Scientist to join our Aetna Medicare (STARS Portfolio) team at CVS Health. This high-level individual contributor will partner ... closely with the Executive Director of Aetna STARS Analytics to drive hands on...business strategies and products + Experience in large, matrixed corporate environment + Experience working with end-users **Education:** +… more
- Humana (Boston, MA)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Takeda Pharmaceuticals (Boston, MA)
- …Biostatistics, Global Emerging Markets (GEM; eg, China), Project Leadership, Finance, Corporate Communications and Business Development + Develop and manage strong ... LOC level Decision-making and Autonomy + Responsibility in line with Associate Director level position; independently lead HE projects and support the Global Health… more
- Fresenius Medical Center (Waltham, MA)
- …+ Ensuring appropriate internal controls, timeliness, accuracy, and adherence to Corporate and governmental policy is maintained. + Ensuring that patient accounts ... accuracy. + Overseeing the monthly close process of the Advantx and Medical Manager sub-systems and providing the accounting department with cash deposits, projected… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... changes at the request of the assigned provider. + Adhere to departmental, corporate standards and policy and procedure (ie, Fallon Health Service Level agreements)… more
- Fallon Health (Worcester, MA)
- …is responsible for the presentation of the member appeal to the FH Medical Director , Center for Medicare /Medicaid Services, contracted reviewer, as ... staff. Work with Team Leaders, Department Managers, Department Chairs and/or Medical Director to resolve member complaints; formulate improvement measures… more
- Tufts Medicine (Lowell, MA)
- …experience required or combination of at least one year of acute medical /surgical nursing experience and 2 years of home health experience required. **Preferred ... + Communicates regularly with Clinical Managers as well as with the Clinical Director when issues arise relative to clinical practice or other performance related… more