- 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
- 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
- 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
- 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
- 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
- State of Massachusetts (Boston, MA)
- …Nursing Facilities, Chronic-Disease Rehabilitation Hospitals as well as two coordinated care programs, Senior Care Options (SCO) and the Program of All Inclusive ... Care for the Elderly (PACE). The Deputy Director Personal Care Attendant Program , Fiscal Intermediary...Medicare and Medicaid Services (CMS). * Update existing program regulations (bulletins and other communication) and billing instructions… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Senior Director , Third Party Compliance Oversight reports directly to the SVP, Corporate Compliance & Ethics and Risk ... perform compliance oversight and monitoring of delegated third parties including Medicare FDR; Duals/SNP; and Medicaid/LTSS programs. + Coordinates and reviews work… more
- Commonwealth Care Alliance (Boston, MA)
- …as clincial protocols to reduce variation in care and outcomes. + Partner with Senior Director of Operations, and Paramedic Network Delivery Manager around medic ... eg through conference presentation and/or media opportunities. + As backup to the Senior Director of Operations, Customer Support Manager, and Associate Medical … 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
- Elevance Health (Hingham, MA)
- ** Director of Contracts & Procurement** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services… more
- CenterWell (Boston, MA)
- …a part of our caring community and help us put health first** **National** ** Director of Transitional Care and High-Risk Patient Management** The Director of ... Patient Management (TCM & HRPM) will be responsible for the end-to-end program effectiveness to build and establish operational and strategic goals and objectives… more
- Option Care Health (Boston, MA)
- …developing, and retaining a diverse workforce. **Job Description Summary:** The Director , Compliance Investigations is responsible for developing and maintaining a ... comprehensive compliance investigation program , including managing the company's confidential ethics and compliance hotline, conducting investigations into potential… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Associate Director , Business Systems Analysis performs analysis of business, process and user needs, ... analysis and translation into proper system requirement specifications. The Associate Director , Business Systems Analysis requires a solid understanding of how… more
- Mathematica (Boston, MA)
- …Medicaid, CHIP, Home- and community-based services, Medicaid Finance, Medicaid program and systems transformation, health systems finance, or provider reimbursement. ... Ideally, this person will have prior experience as a senior state health official or comparable role in Medicaid... state health official or comparable role in Medicaid program design and implementation at a public or private… more
- Boston University (Boston, MA)
- …Education and Research programs for the Department of Medicine. Education The Senior Director provides administrative oversight to the Internal Medicine office ... , staff education, policy and procedure coordination, compliance, accreditation, and budgeting. The Senior Director reports to the Vice Chair of Education in the… 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
- Bristol Myers Squibb (Boston, MA)
- …Read more: careers.bms.com/working-with-us . Reporting into the Medical Value Liaison Field Director , the Senior Medical Value Liaison (MVL)/Executive MVL is a ... policy makers, and other decision makers and influencers. **Responsibilities** ** Senior Medical Value Liaison** + Provide comprehensive, accurate, fair, balanced,… 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)
- …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