Displaying 1 - 15 of 26 Jobs.
OCA Training Coordinator
Boston, MA
The OCA Training Coordinator is responsible for developing and maintaining training infrastructure for the Office of Clinical Affairs. Reporting to the Manager of OCA Operations, the OCA...
Boston, MA
The OCA Training Coordinator is responsible for developing and maintaining training infrastructure for the Office of Clinical Affairs. Reporting to the Manager of OCA Operations, the OCA...
NH Contract Manager
Manchester, NH
Assists our provider partners in the interpretation of data tools and analytics provided by the Plan, including Alternative Payment Arrangements (APMs) and Quality Incentive Programs (QI...
Manchester, NH
Assists our provider partners in the interpretation of data tools and analytics provided by the Plan, including Alternative Payment Arrangements (APMs) and Quality Incentive Programs (QI...
Inpatient Utilization Management Specialist
Boston, MA
Prioritizes and processes incoming requests, including authorizing specified inpatient admissions requests, as outlined in departmental policies, procedures, and workflow guidelines Requ...
Boston, MA
Prioritizes and processes incoming requests, including authorizing specified inpatient admissions requests, as outlined in departmental policies, procedures, and workflow guidelines Requ...
Fee and Reimbursement Regulatory Manager
Boston, MA
Develops, maintains and manages all plan fee schedules and code pricing. Monitors multi state regulations including DHHS, EOHHS, and CMS websites, listservs and other sources to identify...
Boston, MA
Develops, maintains and manages all plan fee schedules and code pricing. Monitors multi state regulations including DHHS, EOHHS, and CMS websites, listservs and other sources to identify...
Care Manager SCO
Boston, MA
Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral...
Boston, MA
Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral...
Senior IT Project Manager
Boston, MA
Responsible for the coordinated management of multiple large scale, critical or complex projects. The Senior IT Project Manager (PM) is responsible for overseeing all aspects of project...
Boston, MA
Responsible for the coordinated management of multiple large scale, critical or complex projects. The Senior IT Project Manager (PM) is responsible for overseeing all aspects of project...
Credentialing Coordinator I
Boston, MA
Initiates the collection of all pertinent information/documentation from Providers and their office staff. Verifies credentials through the appropriate primary sources. Independently rev...
Boston, MA
Initiates the collection of all pertinent information/documentation from Providers and their office staff. Verifies credentials through the appropriate primary sources. Independently rev...
Project Coordinator
Boston, MA
The Project Coordinator (PC) will work closely with Project and Program Managers to ensure the success of strategic initiatives at WellSense. PCs assist with the preparation and maintena...
Boston, MA
The Project Coordinator (PC) will work closely with Project and Program Managers to ensure the success of strategic initiatives at WellSense. PCs assist with the preparation and maintena...
Manager of Consumer Sales
Boston, MA
The Manager of Consumer Sales is a sales leader focused on sales growth for our Massachusetts Senior Care Options (SCO) product. Working closely with the VP of Sales, the Manager will de...
Boston, MA
The Manager of Consumer Sales is a sales leader focused on sales growth for our Massachusetts Senior Care Options (SCO) product. Working closely with the VP of Sales, the Manager will de...
Bilingual/Spanish Member Service Reps (Work from Home)
Boston, MA
Utilize appropriate resource materials to own interactions in order to effectively and accurately interpret respond and resolve customer inquiries and problems while delivering outstandi...
Boston, MA
Utilize appropriate resource materials to own interactions in order to effectively and accurately interpret respond and resolve customer inquiries and problems while delivering outstandi...
Payment Policy Manager
Boston, MA
Develops and maintains corporate payment policies, and works collaboratively with the Clinical Editing Manager to ensure consistency with the Plan's adjudication system(s) Monitors DHHS,...
Boston, MA
Develops and maintains corporate payment policies, and works collaboratively with the Clinical Editing Manager to ensure consistency with the Plan's adjudication system(s) Monitors DHHS,...
Nurse Care Manager SCO
Boston, MA
Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral...
Boston, MA
Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral...
Care Management Coordinator, SCO
Boston, MA
Generates and/or distributes member documents and files Data entry of confidential member information into multiple databases Generates simple reports for care management team Initiates...
Boston, MA
Generates and/or distributes member documents and files Data entry of confidential member information into multiple databases Generates simple reports for care management team Initiates...
Manager of Risk Adjustment and Trend Analytics
Boston, MA
The Manager of Risk Adjustment and Trend Analytics is a key member of the Finance management team. Under supervision of the V.P of Financial Planning and Performance Analysis, the Manage...
Boston, MA
The Manager of Risk Adjustment and Trend Analytics is a key member of the Finance management team. Under supervision of the V.P of Financial Planning and Performance Analysis, the Manage...
Customer Service Trainer
Boston, MA
The Operations Trainer develops a wide variety of training programs and materials to support the Claims, Call Center, and Enrollment teams. The trainer researches, develops, and facilita...
Boston, MA
The Operations Trainer develops a wide variety of training programs and materials to support the Claims, Call Center, and Enrollment teams. The trainer researches, develops, and facilita...