• Manager , Risk Adjustment Operations…

    Point32Health (Canton, MA)
    …of risk adjustment results and the quality, accuracy and identification of member health conditions. The Manager will build relationships and drive risk ... **Who We Are** Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality,...capture of risk adjustment data. To be successful, the Manager will need to rely on strong analytic, consultative… more
    Point32Health (10/24/25)
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  • RN Clinical Manager , Home Health

    CenterWell (Pittsfield, MA)
    …provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused ... part of our caring community and help us put health first** **Work Schedule** : Full-time/40 Hours **Position Type**...at our Pittsfield, MA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services… more
    CenterWell (11/20/25)
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  • Product Owner, Health sciences- Consulting…

    Cognizant (Boston, MA)
    …eligibility verification, and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA), ensuring compliance with ... experience with sales and enrollment processes for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA). . Strong understanding of… more
    Cognizant (11/15/25)
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  • Provider Engagement Manager

    Vatica Health (Springfield, MA)
    …growth and advancement- we love our employees and want to develop within Good Health + Comprehensive Medical, Dental, and Vision insurance plans + Tax-free ... The Provider Engagement Manager (PEM I), is an integral role at...office staff and providers in primary care practices, large health systems and physician organizations is required. Through cross-functional… more
    Vatica Health (10/16/25)
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  • Clinical Manager , RN

    Fallon Health (Springfield, MA)
    … and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the ... **Overview** **About us:** Fallon Health is a company that cares. We prioritize...working condition in collaboration with the Quality and Risk Manager . + Assumes responsibility for inservice education for nursing… more
    Fallon Health (11/14/25)
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  • Enterprise Project Manager lll

    Fallon Health (Worcester, MA)
    …and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of ... **Overview** **About us:** Fallon Health is a company that cares. We prioritize...results. Collaborating with a broad group of stakeholders, Project Manager III will ensure appropriate business objectives are defined… more
    Fallon Health (10/14/25)
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  • Case Manager Assistant

    Baystate Health (Springfield, MA)
    …below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the ... exempt employees. Minimum - Midpoint - Maximum $20.38 - $23.43 - $27.53 Baystate Health is hiring a Full Time Case Management Assistant at Baystate Medical Center.… more
    Baystate Health (11/14/25)
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  • Field Access Manager - Long Island, NY…

    Merck (Boston, MA)
    …sales or operations, project management, or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) ... **Job Description** Field Access Manager The Field Access Manager (FAM)...the products are covered under the benefit design (Commercial, Medicare , Medicaid) * Answer questions about coverage, including payer-specific… more
    Merck (11/27/25)
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  • RN Care Manager - Remote, nationwide

    Humana (Boston, MA)
    **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies, approaches and ... of the business there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare , Medicaid, and/or and Group… more
    Humana (11/19/25)
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  • Manager of Care Management- Pediatric…

    WellSense (MA)
    …It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health ... our members, no matter their circumstances. **Job Summary:** The Manager of Care Management-Pediatric Complex Care is responsible for...WellSense** WellSense Health Plan is a nonprofit health insurance company serving more than 740,000… more
    WellSense (11/20/25)
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