- Commonwealth Care Alliance (Boston, MA)
- …of Delegation Partnerships and Performance, is responsible for advancing provider quality performance across CCA's contracted network , with a focus on ... determinants of health (SDOH) measures. The Program Manager will work collaboratively with our provider network and Quality teams to identify quality … more
- Commonwealth Care Alliance (Boston, MA)
- …operations, utilization management, and quality programs as they relate to provider satisfaction and network performance. - Experience with change management ... quality , compliance, medical management, and analytics teams to advance provider network operations, education, and performance improvement. The Provider… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Facilitate Communications Team in content creation as the subject matter expert for provider network + Maintain inventory of all provider communications ... all letters, emails and newsletters are compliant, uniform to CCA brand standards, and provider -friendly + Work with provider network and data management to… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the ... data analysis, to ensure delegated entities meet contractual, regulatory, and quality standards that optimize member outcomes and operational efficiency. This… more
- Commonwealth Care Alliance (Boston, MA)
- …working with providers. Ensures integration of utilization management functions with network strategy , vendor relationship management and claims processing. ... standards in improvement to promote the development of a high quality team.collaboration with the broader clinical organization. - Ensures that utilization… more
- FleishmanHillard (Boston, MA)
- …team members. + Oversee team workloads and assignments across the account. + Ensure quality and consistency of media strategy and execution. + Collaborate with ... business impact, and navigate a complex media landscape. + Leverage a strong network of relationships with key healthcare, pharma, and business media, showing a… more
- Parexel (Boston, MA)
- …Regulatory Affairs, Tech Ops, etc. for labeling distribution, tracking and quality control. + Utilize regulatory/product knowledge to provide operational ... - you'll be a trusted collaborator whose insights help shape regulatory strategy and ensure patients worldwide receive safe, effective therapies with clarity and… more
- Manulife (Boston, MA)
- …Policy, or related field preferred + 8 -15+ years in provider network management, healthcare contracting, or payer strategy roles + Familiarity with CRM ... long-term care providers to our customers when they need it. The Director, Provider Network Development & Relationship Management, is responsible for leading the… more
- Molina Healthcare (Boston, MA)
- **Job Description** **Job Summary** Sr. Analyst, Network Strategy , Pricing & Analytics guides the investment of our network partners through contract ... plans on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through financial… more
- Commonwealth Care Alliance (Boston, MA)
- …operations, utilization management, and quality programs as they relate to provider satisfaction and network performance. * Experience with change management ... quality , compliance, medical management, and analytics teams to advance provider network operations, education, and performance improvement. The Provider… more
- CVS Health (Boston, MA)
- …Data Interchange (EDI), practice management software, etc. + Prior experience with Provider Network functions / processes and market dynamics. + Working ... Provider Operations organization provides foundational operational / enabling support for provider partners and the Network teams that directly interact with… more
- Evolent (Boston, MA)
- …Strategic Account teams and payer clients to align priorities and deliver high- quality provider network engagement, performance reporting, and present ... territory. You will design and execute strategies that elevate provider performance, enhance care quality , and drive... experience advisory panels + Own market level engagement strategy and collaborate with provider engagement market… more
- Highmark Health (Boston, MA)
- …Act as subject matter expert with recommendations and data supporting development of network and sales strategy and support of leasing contract negotiation. ... Develop and maintain leasing revenue targets. Update network lease risk strategy in response to...continually improve the care and service to members and provide recommendations to internal customer supporting quality … more
- Molina Healthcare (Boston, MA)
- **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial ... to engage with provider and facilitate VBC performance. * Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. *… more
- Humana (Boston, MA)
- …Will also influence the field in terms of which systems to partner with, provide sound contracting strategy as well as contract template development, which will ... strategies within an assigned geographical region and executing upon said strategy . Communicates contract terms, payment structures, and reimbursement rates to… more
- Beth Israel Lahey Health (Cambridge, MA)
- …efficiency results. + Establishing a population health strategy for the network , including efforts to enhance physician and provider integration through ... is responsible for developing and implementing a vision and strategy to drive continued improvement in quality ...+ Report to BILH leadership and BILHPN Board on network operations, provider network , program… more
- IQVIA (Boston, MA)
- …Medical Affairs Strategy ** **Overview** IQVIA is a leading global provider of advanced analytics, technology solutions, and clinical research services to the ... therapeutic and disease areas. This position resides within IQVIA's Medical Affairs Strategy & Excellence Team encourages a dynamic culture that values diversity of… more
- Takeda Pharmaceuticals (Boston, MA)
- …employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice ... therapies to patients worldwide. Join Takeda as Director, Global Regulatory Labeling Strategy where you will be responsible for the development and implementation of… more
- Lilly (Boston, MA)
- …Massachusetts. **The Position** The purpose of the Associate Director, Regulatory Strategy role is to support the development and implementation of innovative ... as assigned. In this role, you'll collaborate across teams to provide regulatory guidance, drive health authority interactions, and manage regulatory submissions.… more
- Meta (Boston, MA)
- …to improve efficiency and manage business risk, our team is accountable. We provide the services to manage network operations across data center, backbone, ... weight solutions in code 7. Data Measurement: As an operations practitioner supporting our network , you will be expected to drive quality into the metrics we… more
