• Home Healthcare Claims…

    CenterWell (Boston, MA)
    …our caring community and help us put health first** The Manager of Pre -Bill Audit provides strategic leadership and operational oversight for the organization's ... pre -billing function. This role is responsible for ensuring all claims are audit-ready prior to release, driving standardization across branches, and delivering… more
    CenterWell (12/18/25)
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  • Risk Management Professional

    Humana (Boston, MA)
    …claims in accordance with TRICARE policy requirements. This role involves reviewing pre -payment, high dollar claims to assess payment accuracy and identify ... **Become a part of our caring community and help us put health first** The Claims Risk Management Professional is responsible for ensuring payment quality of … more
    Humana (12/13/25)
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  • Senior Business Intelligence Data Analyst

    Humana (Boston, MA)
    …years' advanced experience developing complex SQL queries + 1+ years' experience in Healthcare related data ie. Provider, Insurance, etc. + Experience with pharmacy ... claims data + Advanced knowledge of Excel (ex. Pivot...provide work visa sponsorship for this role._** Work at Home /Remote Requirements **Work-At- Home Requirements** + To ensure… more
    Humana (12/17/25)
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  • Lead Analyst, Performance Analytics

    Evolent (Boston, MA)
    …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... **What You'll Be Doing:** + Lead in-depth analyses of healthcare data - including authorizations, claims , membership,...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
    Evolent (11/12/25)
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  • Payment Integrity Coding Professional

    Humana (Boston, MA)
    …escalations. **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home . While this is a remote position, occasional travel to Humana's offices for ... certification experience utilizing coding guidelines by reading and interpreting claims + Exceptional understanding of Centers for Medicare &...hours are 8AM - 5PM Eastern time. **Work at Home Requirements** * At minimum, a download speed of… more
    Humana (12/18/25)
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  • Snr Research Consultant

    Oracle (Boston, MA)
    …MS Excel, MS Word + Highly desirable to have: + Experience using EHR and/or healthcare claims data + Familiarity with Python or other programming language At ... **Evidence Generation Lead/Snr Research Consultant, RWE, Health Outcomes** **Remote/Work from home ** Oracle Life Sciences is seeking a qualified health outcomes… more
    Oracle (12/13/25)
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  • Investigator 1 - FWA Prepayment Review

    Point32Health (Canton, 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
    Point32Health (10/31/25)
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  • Sr. Director, Client Analytics

    Evolent (Boston, MA)
    …seamlessly with diverse teams and stakeholders. + Deep understanding of healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including ... preferred. + 10+ years of analytics & reporting experience in healthcare , including medical economics, cost/utilization analysis, and membership trend reporting. +… more
    Evolent (11/25/25)
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  • Managing Director, Actuarial Services

    Evolent (Boston, MA)
    …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key ... of Actuaries credentials with Group Health track **(Preferred)** + Familiarity with healthcare claim processing **(Preferred)** + 5+ years experience at payer or… more
    Evolent (10/21/25)
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