• Sr . Claims Specialist (Workers…

    Zurich NA (Boston, MA)
    Sr . Claims Specialist (Workers Compensation, NE Region) 129546 Zurich is looking for an accomplished Workers Compensation Sr . Claims Specialist for or ... Jersey, New York, Pennsylvania, Rhode Island, or Vermont. The Senior Workers Compensation Claims Specialist will handle...Litigation Management area.OR + Completion of Zurich Claims Training Program and 6 or more years of experience in… more
    Zurich NA (01/08/26)
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  • Sr . Facets Dental Configuration…

    Cognizant (Boston, MA)
    ** Sr . Facets Dental Configuration Specialist ** **Location: Remote** **Employment Type: Full-Time** **Job ID: 00067013861** **About the role** As a Technical ... decisions and downstream impacts. + **Apply comprehensive knowledge of Medicaid, Medicare , and commercial business rules across configuration activities** . +… more
    Cognizant (01/15/26)
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  • Inpatient Audit Specialist FT 2,500 Sign…

    Datavant (Boston, MA)
    …to realize our bold vision for healthcare. As an **Inpatient Auditing Specialist ** you will be instrumental in addressing consulting and educational needs related ... workspace! **Preferred: In need for a FT IP auditing specialist . Auditing specialist will be responsible for...be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care. Interest in… more
    Datavant (01/13/26)
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  • Healthcare Clinical Documentation…

    Deloitte (Boston, MA)
    Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk ... on Feb 28, 2026 Work you'll do As a Senior Consultant in our Regulatory, Risk, & Forensic Healthcare...financial concerns and other business controversy. A Clinical Documentation Specialist (CDS) works to ensure accuracy and completeness of… more
    Deloitte (11/21/25)
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  • Enrollment & Eligibility Specialist

    East Boston Neighborhood Health Center (Revere, MA)
    …PACE Senior Care Benefits Manager, the Enrollment and Eligibility Specialist will be responsible for the oversight of various services and insurance-related ... + Strong knowledge of MassHealth eligibility + Strong knowledge of the overall Medicare eligibility of Part A, B and D + Verifying all insurances prior… more
    East Boston Neighborhood Health Center (12/19/25)
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  • Provider Specialist

    Fallon Health (Worcester, MA)
    …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE ( Program of All-Inclusive Care for the ... + Escalate critical issues and conflicts to Manager, Provider Data or Sr . Director, Benefit and Provider Configuration as appropriate. + Maintains assignments… more
    Fallon Health (01/07/26)
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  • Nurse Case Manager - Senior Care Options…

    Fallon Health (Lawrence, MA)
    …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE ( Program of All-Inclusive Care for the ... for MassHealth programs such as the personal care attendant program , adult foster care, group adult foster care, and...member, the Clinical Integration team, and Primary Care Providers, Specialist and other community partners, to ensure a cost… more
    Fallon Health (01/13/26)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Boston, MA)
    …+ Not under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid, and is not identified as an "excluded ... Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the… more
    Evolent (12/18/25)
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  • ACO Behavioral Health Case Manager

    Fallon Health (Chelmsford, MA)
    …integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program ... Supports. The BHCM may also refer members to Flex Program as applicable depending upon the ACO the member...member, the Clinical Integration team, and Primary Care Providers, Specialist and other community partners, to ensure a cost… more
    Fallon Health (12/19/25)
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  • Value-Based Programs Principal

    Humana (Boston, MA)
    … Program portfolio. + Develops new/innovative payment designs for specialist physicians and specialty organizations + Standardizes and accelerates innovative ... actuarial, and market teams. The Principal, Value-Based Programs works with senior executives to develop and drive segment or enterprise-wide functional strategies.… more
    Humana (01/13/26)
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