- Sumitomo Pharma (Boston, MA)
- **Title: Sr . Manager , Medicaid Contract Administration** **Location: Remote/occasional onsite (if local to MA). Flexible work/life balance.** Sumitomo ... seeking a dynamic, highly motivated, and experienced individual for the position of ** Sr . Manager , Medicaid Contract Administration.** The Sr . … more
- Elevance Health (Hingham, MA)
- … Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... **Audit & Reimbursement Senior - Medicare Cost Report Audit** **_Location: This is...federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health… more
- Prime Therapeutics (Boston, MA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Pharmacist Account Manager - Remote in Raleigh, NC **Job Description ... solutions to clients. Serves as clinical liaison for assigned Pharmacy contract (s) and manages overall client relationship. Participates in the development of… more
- Humana (Boston, MA)
- …of the appropriate courses of action. **Humana Government Business government contract requires US citizenship for this position.** **Role Responsibilities** Tasks ... management activities for assigned areas. Ensures full compliance with contract requirements, policies and procedures, and performance standards. Coordinates and… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** Reporting to the Sr Director, **Quality Performance and Value Based Care,** the Provider and Facility Quality & Safety ... Manager is responsible for designing and executing quality measurement...on CCA's Population Health goals; including Medicare Star measures, Medicaid -Medicare Plan withhold measures, quality performance metrics incorporated into… more
- Fallon Health (Worcester, MA)
- …for compiling reports and analyzing data and making program level recommendations. The Manager supports the Senior Director, PACE Operations to manage program ... to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of purpose:** The… more
- Mathematica (Boston, MA)
- …for successful delivery of large technology and data client projects with total contract value up to $50M; and leading large teams comprising of employees and ... some of our largest clients, including the Centers for Medicaid & Medicare Services (CMS) and other agencies. Most...or third-party recruiters. Please do not contact technical or senior staff at Mathematica or share unsolicited resumes. All… more
- Highmark Health (Boston, MA)
- …underlying systems that support the respective business platforms for the Medicaid Business Unit market served by Highmark. Performs configuration change management ... and onboarding of new plans/providers. Translates configuration rules, fee schedules, contract terms, provider data code sets, and benefits into systems parameters… more
- State of Massachusetts (Boston, MA)
- …is led by the Director of Program Integrity, who reports to the Deputy Medicaid Director, and consists of 10 internal staff members and dozens of contractors ($50M ... in annual contract value). MassHealth currently works in a hybrid in-person...federal entities such as the Centers for Medicare and Medicaid Services, State Auditor's Office, and Office of Inspector… more