- Commonwealth Care Alliance (Boston, MA)
- …and extracts into format usable in analytical database + Works collaboratively with Business Intelligence unit and fellow Compliance team members to ... the FDR program, as well as responsibility for first-level Compliance review in onboarding of new business ...contacts due to needs of the program, Medicare, or Medicaid . + Coordinates, with the Compliance Manager,… more
- Commonwealth Care Alliance (Boston, MA)
- …to ensure compliance . + Works closely with the Governance, Risk & Compliance (GRC) teams (Medicare, Medicaid , Privacy, Fraud, Waste & Abuse) for ... vendor management, health insurance government products and programs (Medicare, Duals/SNP, Medicaid , LTSS), and/or compliance experience required, on the… more
- Humana (Boston, MA)
- …implement regulatory compliance policies and procedures + Research regulatory compliance issues and make business recommendations that assure compliance ... needed + Provide compliance guidance, direction, and compliance risk assessment to assigned business partners...on process and quality + High level of emotional intelligence + Ability to work independently and utilize excellent… more
- HealthEdge Software Inc (Boston, MA)
- …upstream, and all aspects of claims operations are centralized for comprehensive business intelligence . The complete suite of solutions fromHealthEdgedelivers a ... **Overview** **Overview:** The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting… more
- Commonwealth Care Alliance (Boston, MA)
- …a vision and strategy for Internal Audit, internal controls, and Sarbanes-Oxley (SOX) compliance in alignment with CCA's priorities and business objectives while ... plan and activities, and that supports and facilitates organizational strategy, business objectives, and effective financial, operational, compliance and… more
- Commonwealth Care Alliance (Boston, MA)
- …to Us:** The Vice President, Quality & Controls Assurance reports to compliance leadership, and strategically and operationally leads various quality reviews of ... coding, call monitoring, system technology upgrades, and other critical compliance /financial/operational controls and processes across the CCA enterprise, including… more
- Commonwealth Care Alliance (Boston, MA)
- …Compliance infrastructure at CCA. + Promote compliance in CCA's business operations with all Medicare and Medicaid contractual and regulatory ... identifying beneficial and value-added audits. + Maintain current knowledge of and identify business and compliance risks using various sources and methods. +… more
- Mathematica (Boston, MA)
- …and privacy in cloud and on-prem environments. This role works across technology, business unit and project teams, with support from the IT Security, Risk and ... Compliance function, in the deployment of a data governance...bias * Exposure to analytics, machine learning and artificial intelligence * Expertise in writing, presenting, discussing and socializing… more
- Point32Health (Canton, MA)
- …that have redundancy and/or lack of scale + Anticipate and scale business controls, regulatory requirements, and compliance activities for improved readiness ... and back-office resources to meet the specific needs of the three lines of business , including Commercial, Medicare and Medicaid **Qualifications - what you need… more
- HealthEdge Software Inc (Boston, MA)
- …upstream, and all aspects of claims operations are centralized for comprehensive business intelligence . The complete suite of solutions fromHealthEdgedelivers a ... we build, evolve, and scale our solutions to meet our growing business . **The Product:** _With Source_ ,we'rechanging the industry narrative, providing a… more
- HealthEdge Software Inc (Boston, MA)
- …upstream, and all aspects of claims operations are centralized for comprehensive business intelligence . The complete suite of solutions fromHealthEdgedelivers a ... and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for… more