- Humana (Boston, MA)
- …improving consumer experiences **Preferred Qualifications** + Masters Degree + Expertise in Medicaid and Medicare managed care + Expertise performing claims data ... team of direct reports to implement operational processes, administer, and evaluate Medicaid VBP models to drive improved provider experience and achievement of… more
- Commonwealth Care Alliance (Boston, MA)
- …as a government contractor and integrated health care services delivery organization , Accountable Care Organization requirements, and insurance ... industry standards and company policies for this growing health care organization with operations in multiple states....Provide counsel to CCA regarding the following issues: + Accountable for understanding federal and state health care… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …East Boston Description: EBNHC is a member of Well Sense, a 501(c)(3) not-for-profit, Accountable Care Organization (ACO) governed by FQHCs. Our mission is ... nurses and physicians on the front line of patient care , to the managers who shape our policies, to...methods may vary based on the needs of the organization and may include telephonic or in person in… more
- East Boston Neighborhood Health Center (MA)
- …in the country. From the nurses and physicians on the front line of patient care , to the managers who shape our policies, to the customer service representatives who ... Time Type: Full time Department: South End Washington Primary Care All Locations: 1601 Washington Street, 400 Shawmut Avenue...high risk patient lists / reports. + Be fully accountable for the completion of work within established timeframes… more
- Commonwealth Care Alliance (Boston, MA)
- …experience strategy that includes members and providers, working collaboratively with leaders accountable for delivering clinical care and provider networks and ... responsible for leading CCA's organizational goal to create best in class member care and service experience across the enterprise . To achieve a consistently… more
- Humana (Boston, MA)
- …model design and strategy with specialty providers, including pay for performance, bundles, accountable care , and shared savings and risk models + Expertise in ... Medicaid and Medicaid managed care ...team. + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications:**… more
- Organon & Co. (Boston, MA)
- …+ Planned Parenthood Federation of America (PPFA) + Title X Grantees + State Medicaid Plans + State FQHCs Administration and Policy Administrators + State LARC or ... with applicable Company policies. **Responsibilities** + The WH-AD will be accountable for the Women's Health business performance, business relationship and… more
- Bristol Myers Squibb (Boston, MA)
- …related experience (field liaison responsible for market access , worked for managed care organization , corporate or field HEOR, etc.) strongly preferred + ... the MVL engages in scientific exchange and enters strategic discussions with health care decision makers as they relate to medical/clinical and health economic and… more
- North Shore Community Health (Peabody, MA)
- …Shield, and the payment plan of any commercial insurer, health maintenance organization , preferred provider organization , accountable health plan, or ... Director, the physician will provide continuing and comprehensive health care for the individual and family across all ages...as a leader and an engaged team member. The Organization North Shore Community Health (NSCH) is a highly… more
- Fallon Health (Worcester, MA)
- …**About Fallon Health** Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of ... serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care … more
- State of Massachusetts (Quincy, MA)
- …and analyze weekly error reports. . Participate in activities related to the yearly Accountable Care Organization (ACO)/Managed Care Organization ... of Birth enrollment process), assisting in the maintenance of the managed care provider and service area relationships in Medicaid Management Information… more
- J&J Family of Companies (Boston, MA)
- …Carolina, NA-US-Virginia, NA-US-New Hampshire, NA-US-Rhode Island, NA-US-Connecticut, NA-US-Tennessee ** Organization ** Johnson & Johnson Health Care Systems ... Johnson & Johnson HCS Inc. Johnson & Johnson Health Care Systems Inc., a member of the Johnson &...to Employer Stakeholders. The Employer Innovation Director will be accountable for building effective stakeholder strategies and engagements that… more
- North Shore Community Health (Salem, MA)
- …* High School Diploma * Must have one year of experience in a health care setting * Understanding of Medicare, Medicaid and managed health care ... North Shore Community Health (NSCH) is a highly accomplished community health organization that prides itself on its compassionate approach to serving the… more
- Fenway Health (Boston, MA)
- …at the Cambridge location. This position is central in helping achieve compliance with Accountable Care organization (ACO) quality goals and measures. As a ... + Work with Medicaid , Medicare, Welfare, Social Security, housing, educational, day care and other institutions to assist patients + Consult with a variety of… more
- Fallon Health (Quincy, MA)
- …region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. The Accountable Care Organization (ACO) Nurse Case Manager (NCM) is an ... to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the… more
- Beth Israel Lahey Health (Reading, MA)
- …as an Addendum to the Job Description_ . **FLSA Status:** Exempt **As a health care organization , we have a responsibility to do everything in our power to ... States of America) The Hospice House Nurse Manager plans and delivers care to patients utilizing the nursing process of assessment, planning, interventions,… more
- State of Massachusetts (Boston, MA)
- …in hospital quality/risk management and must be a Registered Nurse. The CQO is accountable to lead, support and guide the Senior Leadership team in matters related ... * /Collaborates with hospital leaders to develop and implement the organization 's quality and patient safety plan./ * /Oversees the development, review,… more
- Spaulding Rehabilitation (Brighton, MA)
- MDS Coordinator, RN - ( 3282731 ) **Description** **Summary** Accountable for all aspects of the Centers for Medicare and Medicaid (CMS) Resident Assessment ... are identified. * All regulations related to MDS, Medicare PPS and managed care are monitored and supported to ensure compliance. * Accurate claasification of… more
- Evolent Health (Boston, MA)
- …- **Preferred** + Experience working within a health plan, managed care organization , provider operated healthcare environment or Third-Party Administrator ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Walgreens (Worcester, MA)
- …in the billing and submission of claims to government- sponsored health care programs, including Medicare, Medicaid , and all other third-party payers, ... for directing the operation of a Walgreens Local Specialty Pharmacy, and accountable for improving unit sales, profits, and image through the overall development… more