• 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 (09/02/25)
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  • Lead Managed Care Contract Manager

    Baystate Health (Springfield, MA)
    …Project Management: Experience in managing contract-related projects and initiatives is beneficial, as Senior Managed Care Contract Managers may oversee the ... Medicare and Medicaid 4) As a Sr. Managed Care Contract Manager this position will...and contribute to the organization's long-term managed care strategy is often expected in senior more
    Baystate Health (08/30/25)
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  • Senior Patient Care Manager, RN…

    Gentiva (Auburndale, MA)
    …regulations (Medicare, Medicaid , JCAHO, ACHC), and best practices * Familiarity with managed care principles and human resource guidelines * Ability to lead ... strategic oversight? If so, you could be the next Hospice Patient Care Manager Senior on our team. At Gentiva Hospice, we're dedicated to providing compassionate… more
    Gentiva (08/27/25)
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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 Accreditation Utilization Management…

    Humana (Boston, MA)
    …is a plus. + Registered Nurse or Behavioral Health Licensed Professional. + Managed care , Medicaid health plan experience **Additional Information** + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in a team...serve to achieve their best health - delivering the care and service they need, when they need it.… more
    Humana (09/03/25)
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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 (09/02/25)
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  • Care Coordinator / Navigator - Cape Cod

    Fallon Health (Barnstable, MA)
    …criteria, explaining processes for member request determinations and helping members navigate the managed care system + ** Care Team Communication** + Follows ... access to reliable transportation **Experience:** + 2+ years job experience in a managed care company, medical related field, or community social service agency… more
    Fallon Health (08/08/25)
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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 (09/05/25)
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  • Behavioral Health Clinical Program Manager

    WellSense (Boston, MA)
    …related field** **Experience Required:** **.** **5 + years behavioral health specific health care / managed care experience.** **.** **Expertise in ... across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan,… more
    WellSense (08/14/25)
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  • Financial Reporting and Tax Lead - CPA req'd…

    Fallon Health (Worcester, MA)
    …modeling, and analytic assignments** + At least 5+ years of experience in a managed care environment (will consider other relevant health care , social ... to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the… more
    Fallon Health (07/25/25)
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