- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Commonwealth Care Alliance's (CCA) Clinical Care Manager is a registered nurse or other independently licensed behavioral health clinician ... CCA members or patients as part of the job duties. **Required Education (must have):** + RN Clinical Care Managers must have: + Associate degree in nursing +… more
- Commonwealth Care Alliance (Boston, MA)
- …Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary** The Program Manager, in collaboration with the Sr Director of Delegation Partnerships and Performance, is responsible for advancing provider ... incorporate CLAS (Culturally and Linguistically Appropriate Services) standards into provider education and engagement activities. + Lead or support the development… more
- Commonwealth Care Alliance (Boston, MA)
- …medical management, and analytics teams to advance provider network operations, education , and performance improvement. The Provider Relations Director reports ... 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider… more
- Commonwealth Care Alliance (Boston, MA)
- …satisfaction and member access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + ... Lead provider servicing activities, including onboarding, orientation presentations, and ongoing education initiatives. + Serve as a primary resource for resolving… more
- Commonwealth Care Alliance (Boston, MA)
- …meetings, virtual or in person, with CBOs focused on provider education , program operations, regulatory requirements, performance and care team collaboration ... as they relate to delegation programs. - Manages information, education and training to CCA staff, clinicians employed by...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Commonwealth Care Alliance (Boston, MA)
- …role supports efforts of the organization's Network and Provider Contracting department and will have regular interaction with relevant internal Clinical, Quality, ... aimed at leveraging Providers to improve Quality measures** + **Train and Education Provider Network on the measures** + Organize trainings, working with Quality… more
- Commonwealth Care Alliance (Boston, MA)
- …to provider sites. Visits may include regular operations meetings, staff education , provider orientations, and appreciation events. + Facilitate and lead orientation ... and appeals; Policies and procedures. + Identify opportunities for training and education . + Conduct site visits with contracting, sales and marketing departments to… more
- Commonwealth Care Alliance (Boston, MA)
- 082310 InstED-Medical Expenses **Position Summary:** Reporting to the CMO/Medical Director and Associate Medical Director of instED, the Virtual Medical Control ... and follow-up needs + Attend required onboarding, training, and online compliance education courses + Protect patient confidentiality + Provide clinical care to… more
- Commonwealth Care Alliance (Boston, MA)
- …behavioral health providers and driving performance improvement through data insights, education , and partnership. This individual will serve as the primary point ... quality care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: - No,… more
