- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the ... Management Manager. * Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but not limited… more
- 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) ... ability to work independently or in team settings. + Prior experience working with EDPS data flows and Medicare...and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants… more
- Allied Universal (Pittsfield, MA)
- …are subject to state and/or local laws and regulations and may be required prior to employment. *A valid driver's license will be required for driving positions only ... **Perks and Benefits:** + Health insurance and 401k plans for full-time positions + Schedules that fit with your personal life goals + Ongoing paid training programs and career growth opportunities + Employee discounts through our perks program to your… more
- Commonwealth Care Alliance (Boston, MA)
- …participant, care giver or provider accommodations or interpreter needs are secured prior to meeting** **Share and present outcomes of Committee meetings that ... 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 (Boston, MA)
- …a managed care environment is strongly preferred. + Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician reviewer in ... 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 (Boston, MA)
- …+ Evaluate the effectiveness of the company's medical policies and prior authorization program in collaboration with other leads, including via reporting ... 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 (Boston, MA)
- …as Facets, QNXT, or Amisys. **Desired Experience (nice to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly ... 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
- Tufts Medicine (Lowell, MA)
- …program + Current license as a Physician Assistant or Nurse Practitioner in the Commonwealth of Massachusetts + Prior advanced heart failure or acute care ... experience preferred. + Current certification in CPR required + A team player who is excited to work cooperatively with a wide range of stakeholders and disciplines to champions world class patient satisfaction and support **How to apply:** You can submit an… more
- State of Massachusetts (Westfield, MA)
- …setting where your work directly supports the well-being of some of the Commonwealth 's most vulnerable individuals. Working as part of a close-knit law enforcement ... safety protocols in a hospital or campus environment. . Prior experience in a security, law enforcement, or military...by health inequities and structural racism. We envision a Commonwealth with an equitable and just public health system… more
- State of Massachusetts (Boston, MA)
- …Massachusetts Board of Higher Education ("Board" or "BHE") is the Commonwealth 's higher education authority with coordinating and regulatory responsibility for all ... public and private higher education institutions operating in the Commonwealth that are authorized to grant degrees. The BHE is staffed by the Department of Higher… more