- Highmark Health (Boston, MA)
- …Inc. **Job Description :** **JOB SUMMARY** This job is responsible for supervising member service call center and ensuring timely, professional, and courteous ... to other areas as necessary for resolution. Investigate escalated member inquiries. The incumbent may be required to make...routine medical approval decisions. **This role sits within the Medicaid Market - looking for someone who has Customer… more
- Fallon Health (Dartmouth, MA)
- …care and are continually rated among the nation's top health plans for member experience, service , and clinical quality. Fallon Health's Summit ElderCare(R) is ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of purpose:**… more
- Fallon Health (Worcester, MA)
- …care and is continually rated among the nation's top health plans for member experience, service , and clinical quality. We believe our individual differences, ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in… more
- WellSense (MA)
- …facilities and community health centers. Works closely with the Provider Relations Supervisor to identify issues and report trends. Acts as liaison between provider ... and outreach** + **Works collaboratively with Provider Relations Consultants and Supervisor to develop and update provider orientation programs** + **Coaches and… more
- Fallon Health (Dartmouth, MA)
- …care and are continually rated among the nation's top health plans for member experience, service , and clinical quality. Fallon Health's Summit ElderCare(R) is ... be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief Summary of Purpose:** Serves… more
- Fallon Health (Webster, MA)
- …than you have in your current role + Our model is low-volume and very member and quality care focused **About Fallon Health** Founded in 1977, Fallon Health is a ... leading health care services organization that supports the diverse and changing needs...offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique… more
- Fallon Health (Lowell, MA)
- …care and are continually rated among the nation's top health plans for member experience, service , and clinical quality. Fallon Health's Summit ElderCare(R) is ... the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief Summary of...The SE Licensed Practical Nurse will be an active member of the Summit ElderCare Care Team to ensure… more
- Fallon Health (Attleboro, MA)
- …care and are continually rated among the nation's top health plans for member experience, service , and clinical quality. Fallon Health's Summit ElderCare(R) is ... Setting!** + Predictable Hours! + Safe and highly vaccinated work environment including the member population you care for + Our Health Aides and staff love the… more
- Commonwealth Care Alliance (Boston, MA)
- …Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, ... Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse… more
- Tufts Medicine (Lowell, MA)
- **Tufts Medicine Care at Home is a proud member of Tufts Medicine, a health system that is rethinking how academic and community centers, local and national ... businesses, and technology and service innovators can all work together. So that clinicians...Direct, coordinate and evaluate the delivery of home health services . Ensures compliance and consistency with agency policy, State… more
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