- Humana (Boston, MA)
- … compliance as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex ... situations or data requires an in-depth evaluation of variable factors. The Senior Compliance Professional ( Medicaid State Reporting) will be responsible… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Senior Compliance Professional ensures compliance with governmental requirements. ... The Senior Compliance Professional work assignments involve moderately complex to complex issues...+ _Manage, Organize and Monitor the internal Humana Ohio Medicaid mailbox_ + _Create reports, spreadsheets and Power Point… more
- Prime Therapeutics (Boston, MA)
- … Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management Professional (PMP) ... and drives every decision we make. **Job Posting Title** Sr . Compliance Analyst - Remote **Job Description**...or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary: Reporting to the Director, Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr . Specialist II is responsible for ensuring CCA's ... operational compliance with state and federal healthcare regulations, particularly MassHealth...with state and federal healthcare regulations, particularly MassHealth (Massachusetts Medicaid ) and CMS Medicare requirements. This role is housed… more
- Humana (Boston, MA)
- …company committed to improving the health of the communities it serves. The Senior Insurance Product Content Professional will oversee and manage projects for ... of providing frameworks to maximize available resources to achieve growth. The ** Senior Insurance Product Content Professional ** creates content for insurance… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Senior Cloud Solutions Engineer Supports development and execution of cloud implementation strategy ... within organization's existing IT infrastructure. The Senior Cloud Solutions Engineer work assignments involve moderately complex to complex issues where the… more
- Commonwealth Care Alliance (Boston, MA)
- …for One Year Term **Position Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding ... health care reimbursement, public health care programs and reimbursement methodologies ( Medicaid and Medicare) + Medical Coding, Compliance , Payment Integrity… more
- Amazon (Boston, MA)
- …in PBM, health insurance, pharmacy, business development, marketing, managed care, Medicaid , Medicare Part D, and commercial innovation. - Bachelor's degree in ... ideal candidate for this role will have an MBA or equivalent professional experience, highly comfortable with the full go-to-market end-to-end process inclusive of… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid billing-related certifications **Required ... Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr . Analyst plays a critical role in ensuring accurate, compliant, and timely… more
- Prime Therapeutics (Boston, MA)
- …Structure** + Reports to Sr Professional , Manager, Director or Senior Director in the Compliance department Potential pay for this position ranges ... and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) -...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Humana (Boston, MA)
- …between Humana and its trading partners, Medicare and Medicaid . The Senior Encounter Data Management Professional will work with department leadership, ... a part of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful… more
- Prime Therapeutics (Boston, MA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** Job Description The ... Senior Compliance Analyst assists in the implementation...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- CenterWell (Boston, MA)
- …and maintenance of Humana's Healthy Horizon Medicaid business. The Senior Pharmacy Contracting Professional work assignments involve moderately complex to ... in-depth evaluation of variable factors. The Senior Pharmacy Contracting Professional ensures contract compliance and performs analysis regarding pharmacy… more
- Prime Therapeutics (Boston, MA)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior ... Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) Certified Project Management Professional (PMP)… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Senior Contract Management Professional negotiates and maintains complex Subcontract Agreements, ... Company Policy and Contractors' Purchasing Systems Review (CPSR) requirements. The Senior Contract Management Professional also participates in the development… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** We are seeking a Senior Accreditation Professional who will work in a team environment on Humana's health ... plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana. **Role… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Senior Professional , Creative Development collaborates with Stars and Risk Adjustment teams to ... creative writing to educate provider audiences on Humana's initiatives. The Senior Professional , Creative Development work assignments involve moderately complex… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Senior Installation Administration Professional establishes and manages relationships with internal ... cards issued, claims opened for processing and certifications issued. The Senior Installation Administration Professional work assignments involve moderately… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Senior Market Finance Professional collects, analyzes and reports on various market data ... to connect financial outcomes with operational effectiveness. The Senior Market Finance Professional work assignments involve...off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer… more
- Humana (Boston, MA)
- …part of our caring community and help us put health first** As a Senior Enterprise Transformation Professional supporting Humana's Insurance Segment, you can be ... are not limited to the following: + Review expectations and deliverables prepared by senior leadership, business owners and senior level project managers + Build… more