- Tufts Medicine (Burlington, MA)
- …and Medicare Advantage programs, plays a crucial role in overseeing clinical operations , and driving performance improvements within the Tufts Medicine ... MSSP electronic Clinical Quality Measures (eCQMs) or Medicare Clinical Quality Measures (CQMs) and quality...Works closely with Care Management leadership to manage daily clinical operations and oversee clinical … more
- Humana (Boston, MA)
- …and help us put health first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and providers, with full ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager ... sits in the center of strategy, design, technology, clinical , and operations and is responsible for… more
- Tufts Medicine (Burlington, MA)
- …and oversight to Utilization Review departments and UM vendor management. The UM Operations Manager is responsible for compliance with CMS Conditions of ... the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization Program that integrates… more
- Point32Health (Canton, MA)
- …and monitor physicians' prescribing trends and drug utilization patterns for clinical appropriateness and cost-effectiveness with the Plan's operations and ... to our members, partners, colleagues and communities. **Job Summary** The Senior Clinical Pharmacist is responsible for the development and maintenance of multiple… more
- Tufts Medicine (Lowell, MA)
- …+ Works collaboratively with all disciplines, facilitating productivity, cooperation and efficient operations . + Assists in clinical manager 's and scheduling ... of each individual in relation to established standards in collaboration with the clinical manager . + Determines staff competency in a fair and consistent… more
- Option Care Health (Brookline, MA)
- …as office administrator with the pharmacy manager in the absence of the Operations Manager and/or Director of Operations . Serves as the Administrator ... and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health...Manager is responsible for assisting the Director of Operations and/or Area Director of Nursing in meeting operational… more
- Humana (Boston, MA)
- …to the Director, Case Management and supports the strategic priorities for Clinical Operations , Medical & Behavioral Health and Humana Government Business ... government customer and other HGB departments. Interfaces with quality management and clinical operations programs ensuring beneficiary coordination of care. +… more
- Beth Israel Lahey Health (Burlington, MA)
- …a difference in people's lives.** Under general direction, the Research Program Manager will be responsible for managing, promoting, cultivating and overseeing all ... aspects of research, including management of a clinical research department(s). **Job Description:** **Essential Duties & Responsibilities, including but not limited… more
- Datavant (Boston, MA)
- …platform needs and workflows. + Work closely with internal stakeholders (eg, Operations , Clinical , Engineering, and Customer Success) to ensure that analytics ... to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and… more
- Commonwealth Care Alliance (Boston, MA)
- 011520 CCA-Customer Service **Position Summary:** The Manager , Reporting Analytics and Technology is responsible for driving data and analysis informed decisions, ... managing all data and operations information collection on targeted variables on a systematic...Member Communication, Training and Quality_ ] functional areas and/or clinical lines; managing outcomes and process measures; collecting and… more
- CenterWell (Boston, MA)
- …focus in one or more key areas, as assigned, such as care model development, clinical operations , quality & clinical excellence, and technology enablement & ... that include a physician from each of the regions. **Effectively Partner as Dyad Clinical Leader** + Partner cohesively with National Operations Leader as a… more
- Fallon Health (Lowell, MA)
- …and business administration. + Recruits and hires staff. Supervises and evaluates Clinical Nurse Manager , Social Workers, Supervisor of Support Services, ... among the nation's top health plans for member experience, service, and clinical quality.Fallon Health operates one of the largest Programs of All-Inclusive Care… more
- Beth Israel Lahey Health (Boston, MA)
- …score approaches, survival analyses), prior experience with administrative ( Medicare ) claims data is preferred. Additional preferred qualifications include ... research explores how state and federal health policies impact care delivery and clinical outcomes. Research in this section is funded primarily by the National… more
- CenterWell (Boston, MA)
- …organizations + Prior knowledge of Value Based Care organizations, specifically around clinical operations and/or Risk Adjustment + Experience in SQL and/or ... area implements and supports strategy and targeted initiatives aimed at increasing clinical efficiencies, processes, education, and compliance as it relates to … more
- Beth Israel Lahey Health (Brookline, MA)
- …Medical Assistant **Job Description:** **Job Summary:** Reports to: Practice Manager or Ambulatory Practice Coordinator with input from assigned physician(s), ... to patients while contributing to the smooth functioning of practice operations . **Department Specific Job Responsibilities:** 1. Provides support to the practice… more