- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to help us transform healthcare? Bring your true colors to blue. The Senior Manager of Medicare Strategy and Business Planning will report to the ... Vice-President of Medicare Strategy and oversee critical business reporting...opportunities for improvement or variance from expected outcomes. The senior manager will create multiple presentations on… more
- Amazon (Boston, MA)
- …This role will spearhead business development solutions for Amazon Pharmacy payer strategy , driving key growth and profitability goals of the business. Within the ... PBM, health insurance, pharmacy, business development, marketing, managed care, Medicaid, Medicare Part D, and commercial innovation. - Bachelor's degree in… more
- CVS Health (Wellesley, MA)
- …of work supporting multiple lines of Aetna business, including Commercial, Group Medicare , and Medicaid. Your success will hinge on your ability to collaborate ... Recommend, research and develop facts, quotes, and scenarios to support creative strategy and execution. + Ensure messaging, brand guidelines and directives are… more
- CenterWell (Boston, MA)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for … more
- WellSense (Boston, MA)
- Senior Provider Relations Consultant, BH Network Strategy WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and ... New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25...development of training materials** + **Works collaboratively with the Manager of Behavioral Health Network Strategy to… more
- Humana (Boston, MA)
- …- members that qualify for both Medicare and Medicaid. The Lead Product Manager sits in the center of strategy , design, technology, clinical, and operations ... for our members and providers, with full accountability from strategy to execution. The Lead Product Manager ...will ensure effective interaction with all organizational levels, including senior and executive level audiences + Proven ability… more
- Elevance Health (Manchester, NH)
- …Medicaid Services to transform federal health programs._ The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the ... of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and… more
- Elevance Health (Boston, MA)
- ** Strategy & Program Development Director - Payment Integrity Strategy & Planning** **Location:** This role requires associates to be in-office 3 days per week, ... be considered. Travels to worksite and other locations as necessary. The ** Strategy & Program Development Director** is responsible for coordinating the relationship… more
- Prime Therapeutics (Boston, MA)
- …Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality Manager ensures the successful planning, implementation and ... established client quality goals + Drive the client quality strategy for all lines of business ( Medicare ,...quality strategy for all lines of business ( Medicare , Medicaid, Commercial/HIM); serve as primary point of contact… more
- Highmark Health (Boston, MA)
- …growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted business partner, ... Audit Committee. + Prepare regular reports on operational compliance performance for senior management, highlighting key trends and areas for improvement. + Other… more
- CenterWell (Boston, MA)
- …Kentucky, Tennessee, Louisiana, and more. The PCO has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and ... The IPA CMO will develop and support the MSO's National Clinical Vision and Strategy , directly lead a team of regional & area medical directors and serve as… more
- Commonwealth Care Alliance (Wakefield, MA)
- …require intensive care management and care delivery. Within the CIC Program, The Senior Clinician, Behavioral Health (SBHC) serves as a leader for behavioral health ... locations. This position reports to the CIC BH Clinical Manager . **Supervision Exercised:** + No, this position does not...Workers. Provides recommendations to Care Team as to best strategy in managing patients based on psychological drivers for… more