• Medicare Outside Sales - Spanish Required

    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 ... Medicare benefits, including prescription drug coverage. At Fallon Health , we believe our individual differences, life experiences, knowledge, self-expression… more
    Fallon Health (11/17/25)
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  • Eligibility & Revenue Operations Representative-…

    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 ... ensures that enrollee data for Medicare Advantage, Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health... Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health Weinberg and any future regulatory products is entered… more
    Fallon Health (11/18/25)
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  • Sr. Medicare (PPS) Provider Hospital…

    Humana (Boston, MA)
    **Become a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team continue… more
    Humana (12/19/25)
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  • Medicare Stars Analyst

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …recommendations to inform effective member and provider outreach strategies to improve health care outcomes and consumer experience among Medicare population. + ... member of the Government Programs Star Performance team, the Medicare Stars Analyst provides ongoing analytic support to the...analytic support to the development and execution of the health plan's best in class 5-star strategy. In collaboration… more
    Blue Cross Blue Shield of Massachusetts (11/19/25)
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  • Senior Project Manager, Healthcare…

    Humana (Boston, MA)
    …system or health plan. + Experience working in Medicaid and/or Medicare . **Preferred Qualifications** + 3+ years of leadership experience in a matrixed ... **Become a part of our caring community and help us put health first** Humana Healthy Horizons is seeking a Senior Implementation Business Project Manager to manage… more
    Humana (01/16/26)
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  • Lead - Medicaid and Group Medicare Project…

    CenterWell (Boston, MA)
    **Become a part of our caring community and help us put health first** The Project Management Lead manages all aspects of a project, from start to finish, so that it ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-22-2026 **About us**… more
    CenterWell (01/07/26)
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  • Medical Director - IP Claims Management

    Humana (Boston, MA)
    …review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or ... or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice… more
    Humana (12/11/25)
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  • Medical Director - OP Claims Mgmt

    Humana (Boston, MA)
    …review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or ... or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice… more
    Humana (11/24/25)
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  • Medical Director-Payment Integrity

    Humana (Boston, MA)
    …review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or ... or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice… more
    Humana (12/11/25)
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  • Medical Director - Nat'l IP UM Team

    Humana (Boston, MA)
    …review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or ... products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , or other healthcare providers. + Utilization… more
    Humana (11/15/25)
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