- Commonwealth Care Alliance (Boston, MA)
- …Master's Degree preferred Required Experience: + 5-7 years + Experience working in a health care or managed care setting with specific background in contract ... negotiations and management. + Specific background in complex managed care provider contracting including Health Systems, Physician Hospital Organizations,… more
- Commonwealth Care Alliance (Boston, MA)
- …management Desired Experience (nice to have): - Experience working with managed care organizations, value-based programs, or community-based behavioral health ... care for members. In this role, the Program Manager acts as an account manager , relationship...a seamless provider experience and consistent delivery of quality care . The BH Provider Engagement Program Manager … more
- Commonwealth Care Alliance (Boston, MA)
- …high-quality, coordinated care in alignment with the health plan's model of care and strategic objectives. The Manager will also oversee corporate and ... 011230 CA-Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and nurturing… more
- Commonwealth Care Alliance (Boston, MA)
- …) **Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting + 2 or more years working in a clinical setting ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Arup (Boston, MA)
- …client ambitions. We are seeking to hire an East Geography Marketing Winning Work Manager [Energy, Water, & Resources (EWR) ] to strengthen our MCBD function. **What ... the role involves:** The East Geography Marketing Winning Work Manager [EWR] is the senior manager in the East geography marketing team. The role includes… more
- Commonwealth Care Alliance (Boston, MA)
- …experience in provider relations, network management, or healthcare operations within a managed care organization, health plan, or integrated delivery system. - ... leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines of business. This role… more
- Commonwealth Care Alliance (Boston, MA)
- …Strong claims experience + Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/Medicaid) + Experience in health plan ... for building, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital,… more
- Commonwealth Care Alliance (Boston, MA)
- …use **Desired Experience (nice to have):** + 5+ years in health plan or managed care settings **Required Knowledge, Skills & Abilities (must have):** + Ability ... 024800 Clin Alli-Community Health Services **Position Summary:** Commonwealth Care Alliance's Community Health Services (CHS) Department is responsible for… more
- Cardinal Health (Providence, RI)
- ** Manager , Managed Care ** **What Managed Care contributes to Cardinal Health** Practice Operations Management oversees the business and ... administrative operations of a medical practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal… more
- Beth Israel Lahey Health (Boston, MA)
- …not just taking a job, you're making a difference in people's lives.** The Managed Care Coordinator will support the ObGyn Department at Beth Israel Deaconess ... Medical Center in Boston, MA. The Managed Care Coordinator role is a hybrid...instructions and procedures as provided. Work is monitored by supervisor/ manager . + **Written Communications:** Ability to communicate clearly and… more
- Deloitte (Boston, MA)
- ServiceNow Senior Manager - Consulting Managed Services Enterprise Operations as a Service provides multi-year managed service contracts to support ... is where ambition meets opportunity. As a Deloitte Senior Manager , you will have the opportunity to lead and...experience in either: Consumer, Financial Services, Life Sciences Health Care , Technology Media and Telecom, Energy Resources and… more
- Molina Healthcare (Brockton, MA)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Molina Healthcare (West Roxbury, MA)
- …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
- Molina Healthcare (Boston, MA)
- …and cost-effective based on the severity of illness and the site of service. The Care Manager , LTSS provides support for care management/ care ... consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex...care , including at least 1 year experience in care management, managed care , and/or… more
- Commonwealth Care Alliance (Boston, MA)
- …management Desired Experience (nice to have): * Experience working with managed care organizations, value-based programs, or community-based behavioral health ... care for members. In this role, the Program Manager acts as an account manager , relationship...a seamless provider experience and consistent delivery of quality care . The BH Provider Engagement Program Manager … more
- Highmark Health (Providence, RI)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... specialization + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN… more
- Athena Health Care Systems (Lakeville, MA)
- …nurtured to allow you to grow within the company. As an RN Hospice Case Manager , you plan, organize, and direct hospice care . The professional nurse builds from ... facilitates the patient's efforts toward self-sufficiency and optional comfort care . + Acts as Case Manager when...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow… more
- Charter Care Health Partners (North Providence, RI)
- …Care Facilities and agencies, Durable Medical Equipment and Ambulance companies, managed care (insurance) personnel and physician office. Working Conditions, ... Reports to the Director Care Management or designee. Provides coordinated care support to Physician leadership and Clinical Manager (s) of respective… more
- Athena Health Care Systems (Providence, RI)
- We are hiring a Hospice Clinical Manager to join our care team with Athena Hospice of Rhode Island! Salaried role with weekly pay. Mileage reimbursement ... allow you to grow within the company. The Clinical Manager helps oversee the direction of hospice clinical services...of personal characteristics, are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow… more
- State of Massachusetts (Boston, MA)
- …collaboration with staff from the Health Care Access Bureau and Bureau of Managed Care to advise the Commissioner about issues that may impact future ... citizens. *_About the Role:_* The Director of Pharmacy Benefit Manager Oversight operating within the Health Care ...market that have implications in health insurance mandates and managed care practices. * Manage staff working… more
