- Commonwealth Care Alliance (Boston, MA)
- …telephonic case management or primary care . + Experience with a Medicare Advantage population preferred. + Past experience caring for patients/members with ... services via telehealth technologies (video, chat, etc.) for clinically appropriate clinical care and care management services. **Working Conditions:** + … more
- Humana (Boston, MA)
- …such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or ... conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements...MD or DO degree + 5+ years of direct clinical patient care experience post residency or… more
- Humana (Boston, MA)
- …such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or ... and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements,...of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise… more
- Humana (Boston, MA)
- …such as inpatient rehabilitation. **Preferred Qualifications:** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid ... of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid...MD or DO degree + 5+ years of direct clinical patient care experience post residency or… more
- Evolent Health (Boston, MA)
- …for Evolent Primary Care and sub-plans for each business segment (MSSP, Medicare Advantage , and Commercial payer partnerships) + Sets clear goals and ... ECP launched as an internal start-up in 2020 with a wholly owned Medicare Shared Savings Program ("MSSP") Accountable Care Organization ("ACO") spanning four… more
- Humana (Boston, MA)
- …+ Bachelor's degree + Telephonic sales experience + Understanding of value-based primary care and/or Medicare Advantage + Bilingual in English/Spanish with ... service, effectively describes services offered and sell prospective patients on the clinical care model, documents and modifies contact notes across multiple… more
- Humana (Boston, MA)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... in region of assignment + 5+ years of direct clinical patient care experience post residency or...+ Experience in an inpatient environment and/or related to care of a Medicare type population (disabled… more
- Humana (Boston, MA)
- …report directly to the Regional Vice President of Operations in support of the Medicare Advantage line of business. The Market Finance Lead supports all Market ... financial, cost & utilization reporting at all levels + Supports Humana's Medicare Advantage product strategy, budgets, and administrative staffing and expenses… more
- CenterWell (Boston, MA)
- …experience in a Sales or Sales Support position + Understanding of value-based primary care and/or Medicare Advantage + Bilingual in English/Spanish with the ... enrollment, education, engagement, and activation duties for Humana's Primary Care Organization. The Patient Assessment and Navigation Professional contributes to… more
- Humana (Boston, MA)
- …to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries. We accomplish this through an evidence-based approach using ... are living longer, often with more chronic conditions. The Clinical Strategy & Analytics team innovates at the intersection...will be involved in sizing opportunities to mitigate inappropriate care in the healthcare space. The Research Scientist 2… more
- Humana (Boston, MA)
- …enables business partners to improve outcomes and lower costs for millions of Medicare Advantage beneficiaries, using strategic and rigorous test & learn ... skill set in applied research, exploring a range of questions across clinical , operational, and member experience workstreams. **Study design support** * Conduct… more
- North Shore Community Health (Peabody, MA)
- … clinical support staff by providing the safest and highest quality patient care possible. Physicians will support all other clinical staff with assessments, ... a Physician. Under the general direction of the Chief Clinical Officer (CCO) and the direct supervision of the...Director, the physician will provide continuing and comprehensive health care for the individual and family across all ages… more
- Highmark Health (Boston, MA)
- …the Health Plan and its beneficiaries enrolled in risk-adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA) through ... Hierarchical Condition Category (HCC) coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS)… more
- Brockton Hospital (Brockton, MA)
- …of Medicare and Medicaid programs, state insurance and health care laws, HITECH, HIPAA and general Corporate Compliance principles. Maintains up-to-date ... medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference...knowledge of health care legal requirements, and determines if policy revisions or… more
- North Shore Community Health (Salem, MA)
- …* High School Diploma * Must have one year of experience in a health care setting * Understanding of Medicare , Medicaid and managed health care ... serving the surrounding communities with comprehensive and culturally sensitive care . With a strong commitment to excellence, NSCH provides:...day one, and all eligible staff members can take advantage of these benefits right from the start of… more
- Fallon Health (Worcester, MA)
- …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the ... a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon… more