• Database Developer (Healthcare / Risk Adjustment)

    Commonwealth Care Alliance (Boston, MA)
    …development, and maintenance of data systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition Category (HCC) ... provider data. + Familiarity with CMS risk adjustment methodologies and HCC coding preferred . + Experience with data visualization tools such as Tableau, Looker, or… more
    Commonwealth Care Alliance (06/25/25)
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  • Clinical Product Designer (Data Analyst - SQL…

    Commonwealth Care Alliance (Boston, MA)
    …this time._** Position Summary: The Clinical Product Designer (PD) at Commonwealth Care Alliance (CCA) creates actionable, insightful, and intuitive digital products ... Desired Experience: * Population Health or STEM major or related field preferred Required Knowledge, Skills & Abilities: * Experience in presenting data in… more
    Commonwealth Care Alliance (06/25/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the ... process Desired Experience (nice to have): * 3+ years management experience preferred Required Knowledge, Skills & Abilities (must have): * Expertise in managing… more
    Commonwealth Care Alliance (05/21/25)
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  • Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    …the member experience. This position works collaboratively across many departments at Commonwealth Care Alliance (CCA) as well as externally to facilitate timely ... Word or higher **Language(s):** + English + Fluency in Spanish preferred EEO is The Law Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled… more
    Commonwealth Care Alliance (05/21/25)
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  • Member Service Rep

    Commonwealth Care Alliance (Boston, MA)
    …Education: A bachelor's degree in any general or health-oriented field is preferred . Technical accreditation in the health care field (ie, Medical Assistant | ... health care, , health plan, insurance or government is preferred . * Prior experience working in the health care...and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants… more
    Commonwealth Care Alliance (07/10/25)
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  • Engagement Center Associate

    Commonwealth Care Alliance (Springfield, MA)
    …Required: * Associate degree or equivalent experience Education Desired: * Bachelor's degree preferred * BA in Human Services preferred Experience Required: * 2 ... Desired: * 2 years of experience in community-based outreach preferred . * 2 years of direct experience in...and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants… more
    Commonwealth Care Alliance (07/03/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …or state-level Medicaid program, Health Maintenance Organization (HMO); and (b) Preferred Provider Organization (PPO), large Health Care Organization, health plan or ... and general management experience in a managed care environment is strongly preferred . + Primary care discipline, prior experience as Associate Medical Director (or… more
    Commonwealth Care Alliance (06/27/25)
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  • RN, instED Clinical Resource Center

    Commonwealth Care Alliance (Boston, MA)
    …(nice to have):** + Experience in urgent care,primary care, or emergency department preferred + Call center triage experience preferred + Quality and process ... an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for… more
    Commonwealth Care Alliance (07/11/25)
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  • Director, Assessments and Care Planning

    Commonwealth Care Alliance (Boston, MA)
    …**Desired Education (nice to have):** + Nursing License (eg, RN, NP, etc) strongly preferred + Master's degree in business or health related strongly preferred ... + Leadership experience in both health plan and provider organization settings preferred + Solid organizational skills and ability to balance multiple priorities in… more
    Commonwealth Care Alliance (06/07/25)
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  • Sr Advisor, Quality Data Analytics (HEDIS/ Star…

    Commonwealth Care Alliance (Boston, MA)
    …field with strong emphasis in data analysis. Education Desired: * Advanced degree preferred Experience Required: * A minimum of 5 years of relevant experience in ... plus * Experience in data analytics and using data to inform decisions preferred Knowledge, Skills & Abilities Required: * Knowledge of Medicare Star Rating… more
    Commonwealth Care Alliance (07/24/25)
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