- Humana (Boston, MA)
- …for effective risk management and measurement. Join us in shaping the future of healthcare through AI excellence. We are seeking a Lead Data Scientist to drive the ... environments. This is a cross-functional role bridging technical safety research , systems engineering, governance, and product implementation. **Key responsibilities**… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- Ready to help us transform healthcare ? Bring your true colors to blue. Position Summary: The leader in this position is responsible for the design, development, and ... our trend management initiatives in the areas of medical policy, payment policy, care management, pharmacy, health and wellness programs, fraud/waste/abuse, behavior… more
- Humana (Boston, MA)
- …Perform routine quality audits on PPI data mining partner concepts to determine payment accuracy, giving immediate feedback to assigned partner(s) as needed + Act as ... initially paid correctly in the system) + Minimum of 2 years Provider Payment Integrity (formally known as Financial Recovery) experience + CAS claims knowledge +… more
- CenterWell (Boston, MA)
- …performance of the offshore coding team and creates strategies to maximize associate output. The **Program Management Lead, Offshore Coding Operations** works on ... with coding leaders/teams. + Monitor quality and address performance gaps. + Research and interpret correct coding guidelines and internal business rules to respond… more
- Humana (Boston, MA)
- …the curiosity and rigor to build next-generation capabilities that improve healthcare delivery, reduce risk and optimize operational performance. If you're ... using Automation capabilities. In addition, this Leader will spearhead the research , evaluation and deployment of Artificial Intelligence (AI) and Generative AI… more
- Humana (Boston, MA)
- …for effective risk management and measurement. Join us in shaping the future of healthcare through AI excellence. We are seeking a Lead Data Scientist to define and ... with humans in real-world environments. This role blends cutting-edge research , robust experimentation, and product-focused execution to improve user trust,… more
- Humana (Boston, MA)
- …of action. The Dental Network Field Contractor communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of ... leads, fee schedule reimbursement, needed travel for in person dental office visits, research of local community events and how Humana can support these events,… more
- Point32Health (MA)
- …health and well-being organization dedicated to delivering high-quality, affordable healthcare . Serving nearly 2 million members, Point32Health builds on the ... behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of… more
- Humana (Boston, MA)
- …for effective risk management and measurement. Join us in shaping the future of healthcare through AI excellence. We are seeking a Lead Data Scientist to guide the ... create safe AI solutions that will revolutionize and improve healthcare experience and outcomes for our customers. Join our...+ Master's Degree and 5+ years of experience in research /ML engineering or an applied research scientist… more
- Humana (Boston, MA)
- …product, and processes. + Utilize documents, websites, and local networks to research and resolve inquiries of agents, involving Member enrollment and company ... pay for this position is $23.00 Per Hour **Preferred Qualifications:** + Associate or bachelor's degree + Prior leadership/supervisory experience + Bilingual in… more