- Commonwealth Care Alliance (Boston, MA)
- …creating a member-centered care plan and helping members access a broad base of support in the care team to advance their goals for independent living, recovery, and ... position requires in person visits to members in their homes and will support members across various locations **Supervision Exercised:** + No, this position does… more
- Commonwealth Care Alliance (Springfield, MA)
- …and programs. The Associate, Engagement Center will provide patient navigation and support for patients with complex medical, behavioral health and social needs. ... report to the Engagement Center Manager. The Associate, Engagement Center will support the innovative programming and operations of the Engagement Center. The… more
- Commonwealth Care Alliance (Boston, MA)
- …Review functions working closely with other medical management team members. + Support the development of utilization management policy initiatives. + Support ... relations to ensure coordinated approach to delivery system providers + Support plan accreditation efforts as determined by Quality Management and Accreditation… more
- Commonwealth Care Alliance (Boston, MA)
- …Medical Director of medical policy, manage the expansion the MP team to support the company's geographic and business expansions, including the centralization of all ... medical policy development,review and dissemination processes. + Support internal business areas in the development, annual review and implementation of policies and… more
- Commonwealth Care Alliance (Boston, MA)
- …strategic relationships with state elected officials, staff, and agencies. + Support the corporate compliance department to interpret and implement applicable ... goal of fostering good will and strong advocacy community support of CCA. + Work collaboratively with the Vice...and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants… more
- Commonwealth Care Alliance (Boston, MA)
- …experienced in working in clinical environments who provides expertise and support in the development and implementation of clinical applications, data and ... in thinking through our best approaches and ensure appropriate data capture to support a data-driven performance culture. In addition, as experts in the system, our… more
- Commonwealth Care Alliance (Boston, MA)
- …audit, compliance, and provider engagement initiatives. This role also provides support in managing provider disputes and escalations requiring detailed pricing and ... regulations, and CMS payment methodologies (eg, DRG, APC, RBRVS). + Support provider appeal reviews and internal payment integrity investigations by providing… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** Position Summary: At CCA, Business Intelligence (BI) provides key decision support to CCA executives and leadership. The BI department is led by the ... with Healthcare Data Domain processes * Experience with tools to support report/analytics creation - SQL, Tableau, Looker, Alteryx, Azure Required Language… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Leading the implementation, and utilization of new or enhanced technologies that support the work of the department and maximize accurate data collection. + ... Managing vendor relationships and oversight as needed to support assessment completion and care plan creation + Developing and maintaining departmental Policies &… more
- Commonwealth Care Alliance (Boston, MA)
- …Hub Team on the annual review of all existing Medical Policies. + Support internal business areas in the development, annual review and implementation of policies ... of company medical policies and prior authorization program. + Support the payment policy and claims teams in the...and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants… more