- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …workgroups and projects as a subject matter expert (SME) + Collaborate with Director and Senior Program Consultants to identify/ implement workflows ... integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through...+ Accurately plan and scope projects; keep project leads, senior consultants, and Director informed of key… more
- WellSense (Boston, MA)
- …The Senior Director ensures a compliant quality based utilization management program . The Senior Director is responsible for the development of and ... Senior Director of BH Clinical Programs... Senior Director of BH Clinical Programs WellSense Health Plan...systems such as Jiva . Experience managing teams in Medicare , Medicaid and duals program . Experience… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... (10) Years of Clinical Practice with Older Adults (Medical Director ) is dedicated full time to the Indiana Pathways...) is dedicated full time to the Indiana Pathways program to assist the Utilization Management, Care Management, and… more
- Baystate Health (Springfield, MA)
- …and research staff on research program management and planning. The Director also advises senior leadership on strategic, administrative, financial, and ... institute setting is required. Reporting to the Chief Research Officer, the Director , Sponsored Programs Administration (SPA) a team at the primary Baystate Medical… more
- Fallon Health (Springfield, MA)
- …in quality and management committees as assigned. + Works closely with the SE Senior Director of Operations in the development and ongoing monitoring of ... and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short....reports concerns in a timely manner to the SE Senior Director of Operations. + Participates in… more
- Fallon Health (Dartmouth, MA)
- …in quality and management committees as assigned. + Works closely with the SE Senior Director of Operations in the development and ongoing monitoring of ... (PACE) in the country. Called Summit ElderCare, Fallon's PACE program helps older adults and their caregivers to avoid...reports concerns in a timely manner to the SE Senior Director of Operations. + Participates in… more
- Centerwell (Boston, MA)
- …pharmacy practice/primary care practice. + 5-7+ years of progressive clinical pharmacy program leadership experience as a manager, director , or higher overseeing ... to a Conviva/CenterWell market location(s) + Experience working in a value-based care, senior care, and/or Medicare managed care **Workstyle** This is a remote… more
- Advocates (Lexington, MA)
- …community that values the ideas and contributions of our staff. The Residential Program Director is responsible for the successful administration and management ... we serve. We put the individual first. Apply Now! (https://careers-advocatesinc.icims.com/jobs/10347/residential- program - director brain-injury-services/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336180790) Broadcast via Social Network **Connect… more
- Pine Street Inn (Boston, MA)
- …creation of all communications and staff education + Work closely with the Senior Director of Payroll Administration on payroll changes and integrity of ... well as offering the most competitive plan within resourcing limitations. The Director will support wellness strategy and program alignment with organizational… more
- Tufts Medicine (Boston, MA)
- …And that starts with our employees. **Job Description** Reports to the Executive Director of Quality and Patient Safety and is responsible for the strategic ... planning, implementation and monitoring of the organization-wide Infection Prevention (IP) program and Plan. This includes but is not limited to: Oversight of the… more
- The Overlook (Charlton, MA)
- Job Description Position Title: Director of Culinary Operations FLSA STATUS: Exempt (Salary) REPORTS TO: Chief Operating Officer; dotted line to Health Center ... Administrator and Independent Living Executive Director SUPERVISES: Chef de Cuisine - Health Center Culinary...and maintains the strategic vision of the overall culinary program . + Defines and refines culinary concepts per venue,… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Associate Director , Value-Based Solutions will be responsible for leading the operational performance of ... Horizon's specialty value-based payment (VBP) model portfolio. The Associate Director will oversee a team of direct reports to...and existing VBP models. + Ensure data integrity in program administration for new value-based program . +… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director , Privacy and Security directs and manages Commonwealth Care Alliance's (CCA) efforts to ensure compliance with ... the progress of the implementation of the HIPAA privacy & security compliance program at CCA including affiliates and related entities + Works with legal counsel,… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Associate Director , Business Intelligence will be responsible for leading the operational performance of ... Overseeing a team of highly specialized professional associates, the Associate Director will implement operational processes to support payments and reporting for… more
- Fallon Health (Dartmouth, MA)
- …experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an ... alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …your true colors to blue. What We Need Reporting to the Associate Director of Professional Reimbursement Strategy, the Payment Policy and Network Coding Sr. Manager ... meetings and on organizational project teams, and frequently interact with senior leaders, and/or functional peer group managers. + Develop business requirements… more
- Fallon Health (Worcester, MA)
- …information, visit fallonhealth.org. **Brief Summary of Purpose:** Principle responsibility of the Medicare 5 star Program Manager is to collaborate with Fallon ... trends as well as prioritize and recommend improvements through data-driven analysis. The Medicare 5 star Program Manager will also be responsible for… more
- Fallon Health (Worcester, MA)
- …The Manager works closely with their counterpart to assist the Senior Director , PACE Operations to manage the program level operational and regulatory ... analyzing data and making program level recommendations. The Manager supports the Senior Director , PACE Operations to manage program level operational… more
- Commonwealth Care Alliance (Boston, MA)
- …Exercised: Yes. Direct Reports Include the Director of Member Service, Director of Provider Service, Senior Director of Member Communications, ... of Business Strategy and Technology, Director of Member Experience and Improvement, Senior Director of Consumer Affairs, and the Director and Senior… more
- Fallon Health (Worcester, MA)
- …Provider Relations, etc.). + Researches, analyzes and presents recommendations to Senior Director regarding contractual and financial decisions. + Manages ... provider network; physician, hospital, ancillary, and/or carve out vendor as assigned by Senior Director or Manager. + Prepares, updates and maintains files and… more