• Director of Revenue Cycle

    Ophthalmic Consultants of Boston (Plymouth, MA)
    …including 3+ years in a director-level role + Expertise in billing operations, payer relations , call center leadership, and staff development + Deep ... understanding of coding standards (ICD-10, CPT, HCPCS) and insurance processes + Proficiency with EHR and PM systems like Epic, Athenahealth, eClinicalWorks, or NextGen + Strong communication and leadership skills to work across departments and with executive… more
    Ophthalmic Consultants of Boston (08/27/25)
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  • Retail Pharmacy Technician Trainee

    Beth Israel Lahey Health (Boston, MA)
    …in Healthcare or Retail Pharmacy. Knowledge of prior-authorization workflows, payer relations , prescription claims adjudication, and general reimbursement ... procedures. Ability to develop strong relationships with diverse groups of professionals (physicians, nurses, administration, etc. Experience with computer systems required, including web based applications and some Microsoft Office applications which may… more
    Beth Israel Lahey Health (08/13/25)
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  • Retail Pharmacy Technician

    Beth Israel Lahey Health (Boston, MA)
    …in Healthcare or Retail Pharmacy. 4. Knowledge of prior-authorization workflows, payer relations , prescription claims adjudication, and general reimbursement ... procedures. 5. Ability to develop strong relationships with diverse groups of professionals (physicians, nurses, administration, etc. 6. Experience with computer systems required, including web based applications and some Microsoft Office applications which… more
    Beth Israel Lahey Health (07/30/25)
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  • Delaware Valley ACO Fellowship

    Humana (Boston, MA)
    …data reporting, performance improvement, physician engagement, informatics, network development, and contract/ payer relations . This design gives the Fellow the ... opportunity to build fundamental communication, analytic, and problem-solving skills as well as an understanding of the ACO environment and population health strategies. To complement on-the-job training, fellows are involved in Board and other administrative… more
    Humana (07/30/25)
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  • Regional Account Director, New England North

    Sanofi Group (Cambridge, MA)
    …Regional Account Director will demonstrate strong relationships with Trade/Industry Relations , Medical and Pharmacy Directors (clinical and administrative), Case ... sales and sales leadership teams, to ensure consistent exchange of important payer insights and messaging. The Regional Account Director will provide periodic market… more
    Sanofi Group (08/10/25)
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  • Provider Data Auditor

    Fallon Health (Worcester, MA)
    …staff will perform an audit sampling of provider data within the symplr Payer application. Completes a score form in a Microsoft Access tool, prepares audit ... **Primary Job Responsibilities** * Reviews configuration of providers in the symplr Payer (eVIPs) application for accuracy * Organizes and prioritizes workload to… more
    Fallon Health (08/21/25)
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  • Manager, Prior Authorization RN

    Fallon Health (Worcester, MA)
    …related issues, including but not limited to Sales, Claims, Provider Relations , Communications, Appeals and Case Management. + Strictly observes the HIPPA ... five years' experience as a utilization nurse in a payer or facility setting highly preferred. + Discharge planning...active participant in Clinical Rounds + Experience in a payer setting, managed care preferred. + Excellent verbal and… more
    Fallon Health (08/14/25)
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  • Physician Liaison / Outreach Coordinator

    OptiMindHealth (Quincy, MA)
    …and/or breakdowns that would be critically important to long term referral relations and recommend solutions to OptiMindHealth's Director of Physician Relations , ... 2. Understanding of the practice of medicine including referral relationships, payer requirements and other economic and clinical influences. 3. Experience and… more
    OptiMindHealth (08/07/25)
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  • Ld Director, Medicaid Provider Compliance

    CVS Health (Boston, MA)
    …with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure alignment with regulatory and contractual obligations. The Lead ... key liaison between Compliance, Legal, Network Contracting, and Provider Relations teams. **Required Qualifications** + A minimum of 7...Qualifications** + A minimum of 7 years of healthcare payer experience, with at least 5 years in provider… more
    CVS Health (08/20/25)
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  • Revenue Cycle Manager

    Vitra Health (Braintree, MA)
    …months); and, + Interacts with Vitra departments and outside vendors and payer representatives to address account resolution barriers. + Supervises month end revenue ... to health service financial accounting and billing + Principles of patient relations and customer service + Principles and practices of continuous quality… more
    Vitra Health (08/16/25)
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