- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The RoleThe Clinical Care Manger is responsible for facilitating care for members and ... health care disparities, social determinants of health, and any barriers to care . The Clinical Care Manger will engage members in appropriate plans of … more
- Humana (Boston, MA)
- …such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid and/or ... conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements...MD or DO degree + 5+ years of direct clinical patient care experience post residency or… more
- Humana (Boston, MA)
- …such as inpatient rehabilitation. **Preferred Qualifications:** + Knowledge of the managed care industry including Medicare Advantage , Managed Medicaid ... of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid...MD or DO degree + 5+ years of direct clinical patient care experience post residency or… more
- Humana (Boston, MA)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... Utilization management experience in a medical management review organization, such as Medicare Advantage , managed Medicaid, or Commercial health insurance. +… more
- CenterWell (Boston, MA)
- …+ Bachelor's degree + Telephonic sales experience + Understanding of value-based primary care and/or Medicare Advantage + Bilingual in English/Spanish with ... service, effectively describes services offered and sell prospective patients on the clinical care model, documents and modifies contact notes across multiple… more
- Humana (Boston, MA)
- …internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand ... in region of assignment + 5+ years of direct clinical patient care experience post residency or...+ Experience in an inpatient environment and/or related to care of a Medicare type population (disabled… more
- Fallon Health (Worcester, MA)
- …and integrity, ensures that enrollee data for Medicare Advantage , Medicare Supplement, NaviCare, Summit Elder Care , Fallon Health Weinberg and any future ... Fallon Health:** Fallon Health is a mission-driven not-for-profit health care services organization based in Worcester, Massachusetts. For 45...with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider… more
- Humana (Boston, MA)
- …to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries through an evidence-based approach using data analytics, ... a part of our caring community and help us put health first** Humana's Clinical Strategy and Analytics (CS&A) Team is seeking a Research Scientist 2 (Remote).… more
- Humana (Boston, MA)
- …to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries through an evidence-based approach using data analytics, ... a part of our caring community and help us put health first** Humana's Clinical Analytics Team is seeking a Senior Research Scientist (Remote). Our team identifies… more
- North Shore Community Health (Peabody, MA)
- … clinical support staff by providing the safest and highest quality patient care possible. Physicians will support all other clinical staff with assessments, ... a Physician. Under the general direction of the Chief Clinical Officer (CCO) and the direct supervision of the...Director, the physician will provide continuing and comprehensive health care for the individual and family across all ages… more
- Brockton Hospital (Brockton, MA)
- …of Medicare and Medicaid programs, state insurance and health care laws, HITECH, HIPAA and general Corporate Compliance principles. Maintains up-to-date ... medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference...knowledge of health care legal requirements, and determines if policy revisions or… more
- Highmark Health (Boston, MA)
- …Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills ... but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid… more
- Highmark Health (Boston, MA)
- …Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills ... but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and… more
- North Shore Community Health (Salem, MA)
- …* High School Diploma * Must have one year of experience in a health care setting * Understanding of Medicare , Medicaid and managed health care ... serving the surrounding communities with comprehensive and culturally sensitive care . With a strong commitment to excellence, NSCH provides:...day one, and all eligible staff members can take advantage of these benefits right from the start of… more
- Fallon Health (Worcester, MA)
- …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the ... a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon… more