• Medicaid Product Manager

    Humana (Providence, RI)
    …our caring community and help us put health first** The Medicaid Clinical Operations Intake Product Manager applies professional concepts, industry ... by precedent and professional standards with some interpretation. The Medicaid Clinical Operations Intake Product Manager 2 - leads all phases of the … more
    Humana (11/12/25)
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  • Manager , Risk Adjustment Operations…

    Point32Health (Canton, MA)
    …and reporting activities for risk adjustment programs and initiatives that impact Medicare, Medicaid , and Duals product members. This individual will lead the ... and recommend changes to improve program results and effectiveness. The Manager will collaborate with key internal stakeholders ( Clinical , Contracting,… more
    Point32Health (10/24/25)
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  • Nurse Case Manager - Senior Care Options…

    Fallon Health (Foxborough, MA)
    …medication reconciliations o Performs Care Transitions Assessments - per Program and product line processes o Utilizing clinical judgment and nursing assessment ... the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge,… more
    Fallon Health (10/28/25)
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  • Multi-Specialty Account Manager - Boston…

    Lundbeck (Boston, MA)
    Multi-Specialty Account Manager - Boston South, MA Requisition ID: 6949 Location: Boston, MA, US **Territory: Boston South, MA - Multi-Specialty** Target city for ... candidate will have the ability to be a specialty product expert with an understanding of requisite market complexities...the primary care and neurology settings. As an Account Manager , you lead the promotion of our psychiatry portfolio,… more
    Lundbeck (10/23/25)
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  • IT Program Manager - Medicare

    Insight Global (Woonsocket, RI)
    …experience as a Program Manager or RTE * Experience with Medicare, Medicaid or healthcare within claims, provider contacting, product benefits, etc. * ... Job Description Insight Global is seeking a Program Manager to support a large health insurance client...Team Coordination: Work closely with cross-functional teams (including IT, clinical , and operational teams) to ensure project objectives are… more
    Insight Global (11/06/25)
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  • Navigator, Senior Care Options - Plymouth - Hybrid

    Fallon Health (Plymouth, MA)
    …coordinate after care needs + The Navigator refers to the Nurse Case Manager /PCP whenever clinical decision making is required. **Responsibilities** **Note: Job ... provider sheets as applicable + **Access to Care** + Depending upon the product , generates requests and authorizations for Medicaid covered services per the… more
    Fallon Health (10/22/25)
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