- US Tech Solutions (Canton, MA)
- …coverage for multiple products / lines of business; such as state specific Medicaid and Senior Products (Medicare Advantage and SCO). The Clinical Reviewer ... Job Description: Duration: 4 months contract (with possible extension) Mon-Fri (8.15 am -...works under the general direction of the Precertification Team Manager or department Manager . The Clinical Reviewer… more
- Sumitomo Pharma (Boston, MA)
- …seeking a dynamic, highly motivated, and experienced individual for the position of Sr . Manager , Medicaid Contract Administration. This position ... is responsible for managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting ...Compliance, and Legal) to clarify policy compliance requirements and contract language clauses. + Keep current on regulatory and… more
- CVS Health (Boston, MA)
- …next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, conduct high-level ... market-based, behavioral health groups and facility providers. You will manage contract performance and support the development and implementation of strategic,… more
- CenterWell (Boston, MA)
- …of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and address ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve moderately complex...payment model programs via the Center for Medicare and Medicaid Services (CMS), such as ACO REACH, MSSP, and… more
- Atrius Health (Newton, MA)
- …supervision on routine but productive assignments. Typically reports to a finance manager or director. *_Essential Functions_* * * Knowledge regarding current and ... evolving provider payment methodologies . Reviews and monitors contract /payer performance . Compares expected reimbursement data to negotiated rates from contract… more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... us on Facebook, Twitter and LinkedIn. **Brief Summary of Purpose:** The Senior Provider Relations Representative serves as primary liaison for operational matters… more
- US Tech Solutions (Canton, MA)
- …coverage for multiple products / lines of business; such as state specific Medicaid and Senior Products (Medicare Advantage and SCO).** The Clinical Reviewer ... **Job Description:** **Duration: 4 months contract (with possible extension)** **Mon-Fri (8.15 am -...works under the general direction of the Precertification Team Manager or department Manager . The Clinical Reviewer… more
