- Commonwealth Care Alliance (Boston, MA)
- …process. **Supervision Exercised:** + No, this position does not have direct reports. **Essential Duties & Responsibilities:** + Develop enhanced, customized ... and Medicare) + Medical Coding, Compliance, Payment Integrity and Analytics + Direct and relevant experience with HCFA/UB-04 claims management, coding rules and… more
- Fallon Health (Springfield, MA)
- …are continually rated among the nation's top health plans for member experience, service , and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of ... Summary of Purpose:** Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process… more
- Commonwealth Care Alliance (Boston, MA)
- …validation. **Supervision Exercised:** + No, this position does not have direct reports. **Essential Duties & Responsibilities:** + Analyze MassHealth and Medicare ... in the resolution of complex provider disputes and escalations, including direct support to leadership in pricing determinations and dispute case documentation.… more
- North Shore Community Health (Peabody, MA)
- Clinical Nurse Manager Peabody, MA (http://maps.google.com/maps?q=89+Foster+Street+Peabody+MA+USA+01960) Description Primary Purpose of Position: Under the general ... direction of the Director of Nursing, the Clinical Nurse Manager will provide direction and supervision of the... care management. + Insurance enrollment assistance. NSCH operates service sites at Gloucester, Peabody, and Salem Family Health… more
- Family Service Association - Fall River (Fall River, MA)
- …multi-disciplinary team process. The successful candidate must be a flexible and forward thinking nurse who can provide direct care to our clients and work with ... part time (hours per week to be determined) Clinical Nurse Specialist, Nurse Practitioner, or APRN who...talented clinical staff. Education and Requirements: + Masters prepared RN licensed in Massachusetts with Board Certifications as Clinical… more
- Commonwealth Care Alliance (Boston, MA)
- …Provider Engagement. Supervision Exercised: * Yes, this position does have direct reports including Provider Relations Account Managers. Essential Duties & ... processes align with regulatory requirements and organizational standards for service quality and responsiveness. Provider education * Collaborate with Provider… more
- Commonwealth Care Alliance (Boston, MA)
- 011520 CCA-Customer Service **Position Summary** **Individuals with complex health and social needs are often the most vulnerable, costly, and marginalized among us ... recommendations on how best to improve overall care and service delivery. This role is responsible for managing all...into the open for resolution; skilled listener who encourages direct , open, and honest conversation keeping all staff apprised… more
- Beth Israel Lahey Health (Boston, MA)
- …is completed through credentialing. Licensed by the state of Massachusetts as Nurse Practitioner ( RN /NP). Experience with computer systems required, including ... evaluation and competencies for this role are overseen by a Nurse Leader to the department. **Job Description:** **Essential Responsibilities:** Assumes… more
- Humana (Boston, MA)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + BSN or RN required + 3+ years' experience in nursing within a direct ... Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet...achieve their best health - delivering the care and service they need, when they need it. These efforts… more
- Commonwealth Care Alliance (Springfield, MA)
- …on CCA policies, processes, and structures to enhance collaboration and service quality. This position offers broad exposure across multiple organizational areas ... **Supervision Exercised:** + No, this position does not have direct reports. **Essential Duties & Responsibilities:** **Provider Engagement and Relationship… more