• Medicaid Managed Care

    Abt Global Inc. (Cambridge, MA)
    …seeks a Senior Associate with deep policy and management consulting experience relevant to Medicaid Managed Care and managed care organization ... complex technical teams, subcontractors) related to Federal Medicaid and Medicaid managed care required. State experience is not required but a… more
    Abt Global Inc. (08/01/25)
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  • Medicaid Managed Care

    Abt Global Inc. (Cambridge, MA)
    …Global seeks an Associate with policy and management consulting experience relevant to Medicaid managed care monitoring and oversight. The successful ... and maintaining relationships with clients. The candidate will understand Medicaid managed care and the...with ambiguity and changing direction. **What We Value** + Senior Analyst: Bachelor's Degree + Five years of relevant… more
    Abt Global Inc. (08/01/25)
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  • Senior Managed Care Analyst

    Atrius Health (Newton, MA)
    …and welfare benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** * Senior Managed Care Analyst* **Location:** ... innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients...matter expertise in public payer ACO models (Medicare and Medicaid ) and create analyses to assess ACO performance and… more
    Atrius Health (06/04/25)
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  • Senior Professional Business Intelligence…

    Humana (Boston, MA)
    … Professional Business Intelligence Engineer** is an experienced individual with broad Medicaid Managed Care expertise, deep analytics expertise, and ... intelligence, data systems, reporting and data analysis + 3+ years of health care experience for Medicare and/or Medicaid populations + Proven experience with… more
    Humana (07/21/25)
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  • Nurse Care Manager for Senior

    US Tech Solutions (Malden, MA)
    …required. Experience within a SCO program highly preferred. Experience in Medicare and/or Medicaid managed care preferred. Proficient in computer use, the ... administrative direction of the Clinical Manager, the Nurse Case Manager (NCM) for Senior Care Options (SCO) is responsible to manage all aspects of member … more
    US Tech Solutions (07/18/25)
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  • Senior Manager, Network Management,…

    CVS Health (Boston, MA)
    …and/or Medicaid knowledge * 5+ years related experience, proven and proficient managed care network negotiating skills. * 3+ years contracting for large ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...Health, a Fortune 4 company, as the Network Management Senior Manager. In this role, you will manage negotiations,… more
    CVS Health (07/19/25)
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  • Pharmacy Coordinator Senior

    Highmark Health (Boston, MA)
    …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across multiple states. They… more
    Highmark Health (07/22/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …+ 5 or more years of medical management and general management experience in a managed care environment is strongly preferred. + Primary care discipline, ... experience as Associate Medical Director (or equivalent) or physician reviewer in a Managed Care Plan preferred. **Required Knowledge, Skills & Abilities (must… more
    Commonwealth Care Alliance (06/27/25)
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  • Pharmacist - Clinical Advisor

    CVS Health (Boston, MA)
    …willingness to travel up to 40% of the time. **Required Qualifications** - 3+ years of managed care Pharmacist experience and/or 1 year of Managed Care ... team, pharmacists, medical directors, CMO as well as other senior health plan leaders. The Health Plan Clinical Advisor...- Demonstrated experience in a client-facing role within the managed care environment - Demonstrated understanding of… more
    CVS Health (07/29/25)
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  • Utilization Management Nurse

    CenterWell (Boston, MA)
    …+ A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management ... degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or...other opportunities. Application Deadline: 09-30-2025 **About us** About Conviva Senior Primary Care : Conviva Senior more
    CenterWell (08/02/25)
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