- Commonwealth Care Alliance (Boston, MA)
- …Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Value-based program oversight and performance tracking - ... learn new systems and databases that CCA implements. - Working knowledge of Medicare and Medicaid (MassHealth) - Demonstrated skills in Excel and PowerPoint -… more
- Commonwealth Care Alliance (Boston, MA)
- …strong, collaborative relationships with provider partners serving dual-eligible ( Medicare -Medicaid) members. This role ensures providers are well-informed, engaged, ... also oversee corporate and business-as-usual (BAU) communications, support regulatory compliance , and champion digital innovation in provider engagement The Manager… more
- Commonwealth Care Alliance (Boston, MA)
- …plans in partnership with internal and external stakeholders. + Ensure compliance with all regulatory and contractual requirements related to LTSS provider ... **Required Experience (must have):** + 5+ years + Experience with Medicaid and Medicare products and programs + Experience or knowledge of community based services… more
- Commonwealth Care Alliance (Boston, MA)
- …with key healthcare providers, optimizing network performance, and ensuring compliance with regulatory standards. The Director drives initiatives that enhance ... with provider engagement, delegation partnerships, provider services, contracting, quality, compliance , medical management, and analytics teams to advance provider… more
- Commonwealth Care Alliance (Boston, MA)
- …learn new systems and databases that CCA implements. - Working knowledge of Medicare and Medicaid (MassHealth) - Familiarity with and full support of independent ... relationships and collaborate effectively with internal and external stakeholders. - Proactive in identifying issues and developing effective solutions. - Adaptable… more
- Commonwealth Care Alliance (Boston, MA)
- …direct supervision for the Clinical Support Coordinators (CSCs) to ensure proactive administrative clinical team support and accurate, prompt, and courteous service ... staff provide quality patient care and service delivery through proactive work and by responding to inquiries immediately and...to meet team needs. - Adhere to all applicable compliance requirements and the Code of Conduct. - Provides… more
- Sedgwick (Boston, MA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance RN Medicare Compliance - Proactive Reduction Outreach **PRIMARY PURPOSE** ... review, and analysis and interpretation of interventions for the preparation of Medicare Set-Aside allocations. **ARE YOU AN IDEAL CANDIDATE?** We are looking for… more
- Commonwealth Care Alliance (Boston, MA)
- …Required Experience (must have): * 5+ years * Experience with Medicaid and Medicare products and programs * Value-based program oversight and performance tracking * ... learn new systems and databases that CCA implements. * Working knowledge of Medicare and Medicaid (MassHealth) * Demonstrated skills in Excel and PowerPoint *… more
- Commonwealth Care Alliance (Boston, MA)
- …with key healthcare providers, optimizing network performance, and ensuring compliance with regulatory standards. The Director drives initiatives that enhance ... with provider engagement, delegation partnerships, provider services, contracting, quality, compliance , medical management, and analytics teams to advance provider… more
- Commonwealth Care Alliance (Boston, MA)
- …learn new systems and databases that CCA implements. * Working knowledge of Medicare and Medicaid (MassHealth) * Familiarity with and full support of independent ... relationships and collaborate effectively with internal and external stakeholders. * Proactive in identifying issues and developing effective solutions. * Adaptable… more
- CenterWell (Boston, MA)
- …**Use your skills to make an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license ( RN ) with no disciplinary action and ... and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent...a related field + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage… more
