- Commonwealth Care Alliance (Boston, MA)
- …complex issues with a focus on long-term satisfaction and retention. - Lead ongoing communication efforts, working closely with Provider Communications Manager, to ... compliance with CMS, state Medicaid agency, and NCQA standards. - Lead initiatives to streamline provider operations, reduce administrative burden, and improve… more
- Commonwealth Care Alliance (Boston, MA)
- …Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing activities, including onboarding, orientation presentations, and ongoing ... operational efficiency. + **Provider Education and Support:** + Facilitate and lead communication sessions, educating on CCA's policies, program benefits, billing,… more
- Commonwealth Care Alliance (Boston, MA)
- …Duties & Responsibilities:** **Provider Quality Performance and Value-Based Care** + Lead implementation and monitoring of quality initiatives tied to value-based ... **Health Equity and CLAS Integration** + Partner with the Health Equity team to incorporate CLAS (Culturally and Linguistically Appropriate Services) standards into… more
- Parexel (Boston, MA)
- **Project Lead ,** **Meeting Services** We are looking for a Meeting Specialist to join our talented and supportive team of 40+ delivering high quality ... for your clients as you look after projects end-to-end working with a team of likeminded individuals. Qualities such as being highly self-motivated, driven, and… more
- Commonwealth Care Alliance (Boston, MA)
- …contributor on the team , the Senior Analyst is expected to successfully lead projects of any size, scope, and level of complexity, directly engaging with senior ... delivery of projects/reports/analytics and may work independently or in matrixed cross functional team . The expectation is this person can lead a workgroup and… more
- Commonwealth Care Alliance (Boston, MA)
- …relevant Network Providers, including those with delegated arrangements + Review YTD claims files on a monthly/quarterly basis to identify errors and address ... modified for different Provider audiences **Working Conditions:** + This is a remote role with the expectation of working according to Commonwealth Care Alliance's… more
- Sedgwick (Boston, MA)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance ( Remote ) Claims Team Lead - Workers Compensation | AZ, ... activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on ...Excellent negotiation skills + Ability to work in a team environment + Ability to meet or exceed Performance… more
- Humana (Boston, MA)
- …some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, and Humana colleagues. After completion of mentored ... adapt and the courage to innovate **Additional Information** Typically reports to a Lead Medical Director, depending on the line of business. The Medical Director… more
- Zurich NA (Boston, MA)
- …(New York/ NE Region) 127902 Zurich is looking for an accomplished Workers Compensation Claims Team Manager for our Northeast region. This position offers a ... from our Parsippany or Boston offices or a fully remote setup based in one of the following states:...York, Pennsylvania, Rhode Island, or Vermont. Withmeasuredoversight, you will lead and directs a Worker Compensation team … more
- Humana (Boston, MA)
- …healthcare operations, or insurance industry, with at least 1 year in a supervisory or team lead role. **Knowledge & Skills:** + Solid understanding of claims ... a part of our caring community and help us put health first** The Supervisor, Claims Review makes appropriate claim decision based on strong knowledge of claims … more
- Children's Hospital Boston (Boston, MA)
- …into Epic. The IT Epic Manager for Hospital Billing and Claims will lead an established hybrid remote team through support and maintenance activities, ... 82448BRJob Posting Title:IT Epic Manager (Hospital Billing and Claims )Department:IT MOSAIC ProjectAutoReqId:82448BRStatus:Full-TimeStandard Hours per Week:40 Job Posting… more
- Carrington (Boston, MA)
- **Come join our amazing team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred ... to reduce costs and eliminate non-essential and manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including,… more
- Cognizant (Boston, MA)
- **Product Consultant - Facets Claims & Payer Domain** **Work Model: Remote ** **Employment Type: Full-Time** **Job ID: 00066023611** **About the role** As a ... You will be a valued member of the delivery team and work collaboratively with stakeholders across business and...payer domain systems. **In this role, you will:** + Lead the implementation and customization of Facets Claims… more
- Prime Therapeutics (Boston, MA)
- …drives every decision we make. **Job Posting Title** Pricing Analyst Senior - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of ... of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation and analytic insight… more
- Prime Therapeutics (Boston, MA)
- …Experience with data consolidation and modeling **Preferred Qualifications** + Team lead /supervisory/management experience + Business Intelligence consulting ... drives every decision we make. **Job Posting Title** Reporting Principal - Remote **Job Description** The Finance Reporting Principal is responsible for supporting… more
- Prime Therapeutics (Boston, MA)
- …pharmacy with us. **Job Posting Title** Principal Solution Strategist - JUDI - Remote **Job Description** **We are currently on the lookout for a Principal Solution ... Strategist to help lead the Medicare and Medicaid migrations for the JUDI...products + Experience using queries, thorough understanding of pharmaceutical claims data and general understanding of medical claims… more
- Prime Therapeutics (Boston, MA)
- …pharmacy with us. **Job Posting Title** Manager Reporting & Analytics - Remote **Job Description** The Manager Reporting and Analytics is responsible for developing ... to scope, quality, efficiency, budget, schedule and benefit. **Responsibilities** + Lead the development of the department reporting strategy based on compliance… more
- Prime Therapeutics (Boston, MA)
- …drives every decision we make. **Job Posting Title** Sr Solution Strategist - Remote **Job Description** **Calling all Solution Strategists! We are looking for a ... Solutions Strategist to be a part of our JUDI Team . If you are interested in working within a...utilized to provide recommendations on product discovery and definition, lead estimation efforts and delivery at performance review sessions… more
- Prime Therapeutics (Boston, MA)
- …Posting Title** Sr. Solution Strategist - Benefit Configuration - JUDI - Remote **Job Description** **The Senior Solution Strategist - Benefit Configuration** is ... presentations utilized to provide recommendations on product discovery and definition, lead estimation efforts and delivery at performance review sessions + Create,… more
- Prime Therapeutics (Boston, MA)
- …every decision we make. **Job Posting Title** Health Plan Account Manager Sr - Remote **Job Description** The Sr Health Plan Account Manager serves as a line of ... clients, account leaders and internal partners to fulfill client commitments, lead client communications, coordinate product presentations and adoption, and champion… more
