- 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
- Fallon Health (Worcester, MA)
- …medication reconciliations + Performs Care Transitions Assessments - per Program and product line processes + 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
- 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
- Fallon Health (Worcester, MA)
- …among the nation's top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of purpose:**… more
- Fallon Health (Framingham, 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 (Worcester, MA)
- …the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in… more