• Director - Services Alliances

    SHI (Boston, MA)
    …- in our offices or yours.** **Job Summary** SHI is seeking a dynamic and strategic Director of Services Alliances to lead and expand our ecosystem of ... strategy for building and scaling SHI's services alliances ecosystem. + Identify and onboard new service...Serve as the primary point of contact for strategic service alliance partners. **Go-to-Market Enablement** + Collaborate… more
    SHI (10/07/25)
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  • Associate Director , Spec Master's Career…

    Boston University (Boston, MA)
    DIRECTOR , SPEC MASTER'S CAREER DEVELOPMENT, Field Center for Industry Alliances ** **Job Description** **ASSOCIATE DIRECTOR , SPEC MASTER'S CAREER DEVELOPMENT, ... Field Center for Industry Alliances ** **Category** Charles River Campus --> Professional **Job Location**...Career Development works under the direction of the Executive Director of Career Services and Strategy to… more
    Boston University (10/04/25)
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  • Director , Provider Relations

    Commonwealth Care Alliance (Boston, MA)
    011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider ... relations for Commonwealth Care Alliance 's SCO and One Care lines of business. This...network performance, and ensuring compliance with regulatory standards. The Director drives initiatives that enhance operational engagement, member access,… more
    Commonwealth Care Alliance (10/18/25)
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  • Director of State Government Affairs

    Commonwealth Care Alliance (Boston, MA)
    …point of contact with trade associations engaged in state advocacy and supports alliance development with key stakeholders. The Director is responsible for ... 011110 CCA-Public Affairs **Position Summary:** The Director of State Government Affairs (" Director ")...of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered… more
    Commonwealth Care Alliance (07/22/25)
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  • Director , Utilization Management BH

    Commonwealth Care Alliance (Boston, MA)
    …evaluates efficiency and productivity of utilization management functions for physical health services and long term services and supports. Works closely with ... with responsibility for managing the effective utilization of healthcare services , case / disease management, program development/management/evaluation and quality… more
    Commonwealth Care Alliance (10/02/25)
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  • LTSS Program Manager, Hybrid

    Commonwealth Care Alliance (Boston, MA)
    Alliance 's (CCA) contracted community-based organizations (CBOs), including Aging Services Access Points (ASAPs) and Long-Term Services Coordinators (LTSC) ... is responsible for overseeing relationships and performance with community-based Long-Term Services and Supports (LTSS) provider organizations that serve One Care… more
    Commonwealth Care Alliance (10/18/25)
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  • Sr Provider Relations Liaison

    Commonwealth Care Alliance (Boston, MA)
    …building, maintaining and strengthening relationships with the Commonwealth Care Alliance 's (CCA) diverse provider community - including physician, hospital, ... satisfaction and member access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: +… more
    Commonwealth Care Alliance (10/18/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance 's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the ... medical necessity, appropriateness, and efficiency of the use of health care services , procedures, and facilities under the provisions of CCA's benefits plan. The… more
    Commonwealth Care Alliance (10/02/25)
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  • Remote Care Delivery RN Admissions Coordinator

    Commonwealth Care Alliance (Boston, MA)
    023540 Clin Alli-Palliative Care Position Summary: Commonwealth Care Alliance 's (CCA) Care Delivery service lines are responsible for providing care delivery and ... staffed for, provide initial outreach to patients to explain services and schedule initial visits for the assigned clinician....Other projects and requests as made by the Palliative Director * Other duties as assigned Working Conditions: Standard… more
    Commonwealth Care Alliance (10/03/25)
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  • BH Provider Engagement Program Manager

    Commonwealth Care Alliance (Boston, MA)
    …quality care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: * No, ... with cross-functional leaders, including community organizations, PCPs, and social service agencies, to strengthen relationships and community integration. * Partner… more
    Commonwealth Care Alliance (10/18/25)
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  • Provider Communications Manager

    Commonwealth Care Alliance (Boston, MA)
    …engagement The Manager of Provider Communications will report to the Senior Director of Delegation Partnerships and Performance and will support the ongoing ... FAQs and tailored talking points to equip internal stakeholders-including customer service , provider relations, and clinical teams-to effectively address and resolve… more
    Commonwealth Care Alliance (10/18/25)
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  • Database Developer (Healthcare / Risk Adjustment)

    Commonwealth Care Alliance (Boston, MA)
    011260 CCA-Revenue Cycle Management **Position Summary:** Reporting to the Director of Encounter Data Management within the Revenue Cycle Department, the Risk ... and maintenance of data systems and tools that support Commonwealth Care Alliance 's (CCA) risk adjustment and Hierarchical Condition Category (HCC) revenue programs.… more
    Commonwealth Care Alliance (09/24/25)
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  • Manager, Consumer Participation & Engagement

    Commonwealth Care Alliance (Boston, MA)
    011520 CCA-Customer Service **Position Summary** **Individuals with complex health and social needs are often the most vulnerable, costly, and marginalized among us ... is an unmet opportunity.** **Under the direction of the Director Consumer Participation and Engagement, the Manager of Consumer...recommendations on how best to improve overall care and service delivery. This role is responsible for managing all… more
    Commonwealth Care Alliance (10/15/25)
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  • Medicare/Medicaid Claims Reimbursement Specialist

    Commonwealth Care Alliance (Boston, MA)
    …will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a ... scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the… more
    Commonwealth Care Alliance (08/31/25)
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  • Senior Provider Contract Manager

    Commonwealth Care Alliance (Boston, MA)
    …nursing facilities, rehabilitation hospitals, transportation providers, etc.) or long term services and supports (eg Aging Service Access Points, Independent ... superior access to the highest quality, cost-effective providers of healthcare services . Essential Duties & Responsibilities: + Develop, negotiate, manage and… more
    Commonwealth Care Alliance (10/18/25)
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  • Primary Care Triage Nurse

    Commonwealth Care Alliance (Boston, MA)
    …under the general supervision of the Primary Care Manager and Clinical Director . **Supervision Exercised:** + None **Essential Duties and Responsibilities:** + Act ... health plan activities. + Coordination of referrals, specialty visits, testing, social services , skilled services . + Communicate and follow up with skilled… more
    Commonwealth Care Alliance (09/25/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. ... standard coding logic and policies (ie . Center for Medicare & Medicaid Services (CMS) & MA Medicaid, Correct Coding Initiative (CCI), Medically Unlikely Edits… more
    Commonwealth Care Alliance (08/26/25)
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  • MassHealth & Medicare Regulatory Compliance…

    Commonwealth Care Alliance (Boston, MA)
    …will not be considered at this time._** Position Summary: Reporting to the Director , Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. ... into operational actions, collaborating with Claims, Appeals, UM, and Provider Services . * Conduct internal audits and retrospective reviews to identify areas… more
    Commonwealth Care Alliance (09/01/25)
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  • Business Analyst (Process Improvement / Clinical…

    Commonwealth Care Alliance (Boston, MA)
    …compliance. The Senior Business Analyst, Clinical Operations reports to the Director , Clinical Operations Support. This role will provide significant BA support ... and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions… more
    Commonwealth Care Alliance (08/28/25)
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  • Senior Director Partnerships

    Acxiom (Boston, MA)
    …role sits at the intersection of technology, strategy, and revenue generation. The Senior Director will play a pivotal role in architecting the roadmap for MarTech ... alliances , leveraging industry insights and market trends to cultivate...into actionable business plans. The goal of the Senior Director , MarTechStrategic Partnerships and Business Development role is to… more
    Acxiom (09/12/25)
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