- Cardinal Health (Boston, MA)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- Beth Israel Lahey Health (Boston, MA)
- …informed. Represents the various service areas at assigned meetings. 7. Works closely with the Manager of Managed Care Department and shares oversight of the ... to evaluate effectiveness of interventions. Implements relevant information systems, such as managed care , insuring accuracy of data input and patient… more
- Takeda Pharmaceuticals (Lexington, MA)
- …companies and nursing agencies + Work with Regional Business Managers, Patient Access Manager and Managed Care /Government Accounts team + Prior reimbursement ... knowledge. **Job Description** Join Taked as a Patient Support Manager out of our Lexington, MA office. Where you...**_MORE ABOUT US_** At Takeda, we are transforming patient care through the development of novel specialty pharmaceuticals and… more
- Atrius Health (Newton, MA)
- …welfare benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** *Senior Managed Care Analyst* **Location:** *Newton MA - ... Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients at 30 medical… more
- Indeed (Boston, MA)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- WellSense (Manchester, NH)
- Clinical Care Manager WellSense Health Plan is a...Required:** + 3 years related experience in home health care or managed care organization + ... for our members, no matter their circumstances. **Job Summary** The Clinical Care Manager provides holistic medical care management services for members… more
- Molina Healthcare (Waltham, MA)
- …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
- Molina Healthcare (Brockton, MA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Athena Health Care Systems (Webster, MA)
- We are hiring a Unit Manager to join our dynamic care team at Lanessa Extended Care in Webster! Full-time on Monday-Friday 3p-11p. Weekly pay! Working with ... you to grow within the company. As the Unit Manager , you are responsible for the coordination and management...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed centers follow… more
- Gentiva (Auburndale, MA)
- …excellence with strategic oversight? If so, you could be the next Hospice Patient Care Manager Senior on our team. At Gentiva Hospice, we're dedicated to ... live with dignity and comfort. As a Senior Patient Care Manager , you'll help guide branch-level clinical...Medicaid, JCAHO, ACHC), and best practices * Familiarity with managed care principles and human resource guidelines… more
- Molina Healthcare (Boston, MA)
- …and cost-effective based on the severity of illness and the site of service. The Care Manager , LTSS provides support for care management/ care ... consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex...care , including at least 1 year experience in care management, managed care , and/or… more
- US Tech Solutions (Malden, MA)
- …Experience within a SCO program highly preferred. Experience in Medicare and/or Medicaid managed care preferred. Proficient in computer use, the Internet, and ... administrative direction of the Clinical Manager , the Nurse Case Manager (NCM) for Senior Care Options (SCO) is responsible to manage all aspects of member … more
- Athena Health Care Systems (Lowell, MA)
- …to allow you to grow within the company. You plan, organize, and direct hospice care as an RN Case Manager . The professional nurse builds from the resources ... facilitates the patient's efforts toward self-sufficiency and optional comfort care . + Acts as Case Manager when...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow… more
- Athena Health Care Systems (Worcester, MA)
- We are hiring a part-time Registered Nurse (RN) Case Manager to join our dynamic care team at Hospice of Western & Central Massachusetts in Worcester County! ... you to grow within the company. The RN Case Manager plans, organizes, and directs hospice care ...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed centers follow… more
- Athena Health Care Systems (Worcester, MA)
- We are hiring an RN Unit Manager to join our dynamic care team at Parsons Hill Rehabilitation & Health Care Center in Worcester! Full-time on 3p-11p with ... you to grow within the company. As the Unit Manager , you are responsible for the 24-hour coordination and...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow… more
- Commonwealth Care Alliance (Boston, MA)
- …) **Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting + 2 or more years working in a clinical setting ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Athena Health Care Systems (Manville, RI)
- …daily living and facilitates the patient's efforts toward self-sufficiency and optional comfort care . + Acts as Case Manager when assigned by Clinical Supervisor ... individuals, regardless of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and… more
- State of Massachusetts (Boston, MA)
- …collaboration with staff from the Health Care Access Bureau and Bureau of Managed Care to advise the Commissioner about issues that may impact future ... citizens. *_About the Role:_* The Director of Pharmacy Benefit Manager Oversight operating within the Health Care ...market that have implications in health insurance mandates and managed care practices. * Manage staff working… more
- Beth Israel Lahey Health (Boston, MA)
- …expenses on Medicare Cost Report including mgmt of time studies. Liaisons with managed care to optimize contracts. Represent heart transplant with internal and ... process with internal teams for creation of charges, billing workflows and managed care contracting. (essential) 4. Maintains knowledge of regulatory… more
- Elevance Health (Woburn, MA)
- …in acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. + MA RN ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management...Nurse Case Manager II** is responsible for care management within the scope of licensure for members… more