- Humana (Boston, MA)
- …interpretation and independent determination of the appropriate courses of action. The Finance Professional 2 will support Medicaid /Duals and continue ... caring community and help us put health first** The Finance Professional 2 analyzes and forecasts financial,...membership, and premium related data to provide reports to Medicaid Finance CFOs as well as assist… more
- CenterWell (Boston, MA)
- …financial data driven methods to develop and influence drug strategies for the Medicaid lines of business. + Utilizes broad understanding of pharmacy, managed care, ... PBM, market and regulatory insights to support the development of Medicaid formulary and medical drug strategies to mitigate Humana's costs and trend while improving… more
- Humana (Boston, MA)
- …from the data exchange between Humana and its trading partners, Medicare and Medicaid . The Senior Encounter Data Management Professional will work with ... and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of… more
- Beth Israel Lahey Health (Charlestown, MA)
- …just taking a job, you're making a difference in people's lives.** The Director, Revenue Finance and Reimbursement, will be a core member of the Revenue Finance ... a commitment to: (1) Deliver high quality net revenue valuation and related finance models based on transparent and efficient methodologies; (2) Produce data and… more
- Prime Therapeutics (Boston, MA)
- …flows, process change and/or project management in supporting Compliance with Medicaid requirements. + Provide direct, or indirect leadership to other compliance ... + Advise internal clients regarding compliance with State and Federal Medicaid regulatory and contractual requirements + Provides leadership to the business… more
- Humana (Boston, MA)
- …as Dual Eligibles, Veterans, and other needs-based segments. The Medicare and Medicaid organization, Humana's largest, comprises over 80% of the company's total ... in interviews and working sessions with leaders within Medicare and Medicaid and across the broader organization + Conducting industry, market, competitor,… more
- Humana (Boston, MA)
- …users other than those directly employed by the organization. The Senior Finance Reporting Professional / Analyst + Analyzes and forecasts financial, economic, ... our caring community and help us put health first** The Senior Financial Reporting Professional / Analyst prepares and distributes periodic financial statements for… more
- Takeda Pharmaceuticals (Boston, MA)
- …The Head of Contract Management (Director Level) is a highly experience professional responsible for ownership of the Pricing, Value, and Access contracting process ... purchasing organizations (GPOs), wholesalers and distributors. Government contracting includes State Medicaid and the VA Federal Supply Schedule contract. The Head… more
- Humana (Boston, MA)
- …& Clinical Innovation + Corporate Strategy & Transformation Office + Medicare & Medicaid Market Operations + Provider Relations & Network Performance + Marketing & ... Customer Engagement (including MarketPoint) + Finance , Accounting & Risk Management + Human Resources &...in a Master of Business (MBA) or other advanced professional degree (eg MPH, MD, JD, Ph.D.), with a… more
- Beth Israel Lahey Health (Burlington, MA)
- …initiatives. 6. In coordination with Executive Director and Chair, oversees professional staff recruitment activity with Human Resources. 7. Explores, evaluates and ... United Network for Organ Sharing (UNOS) and Center for Medicare and Medicaid Services (CMS). Implements operational policies processes to meet regulations. Develops… more
- Tufts Medicine (Burlington, MA)
- …1. Registered Nurse (BSN or higher) or other licensed clinical professional (PharmD, PA, MD/DO) 2. Current certification in case/utilization management (ACM, ... assigned. 1. **Regulatory & Payer Relations:** Navigates Medicare, Medicare Advantage, Medicaid , and commercial payer rules. Tracks record of overturning medical… more
- Humana (Boston, MA)
- …to detail and organizational skills. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions ... Work is managed and often guided by precedent and/or documented procedures/regulations/ professional standards with some interpretation. **Use your skills to make an… more
- Humana (Boston, MA)
- …directly collaborate with various business partners including initiative owners and finance stakeholders. Candidates pursuing this role should be passionate about ... of Actuaries (ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + MAAA + Strong communication skills +… more