• Commonwealth Care Alliance (Boston, MA)
    011230 CA-Provider Engagement & Performance Position Summary: Commonwealth Care Alliance's Long-Term Services and Supports (LTSS) team is responsible for ... appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a wide range of responsibilities including project management… more
    DirectEmployers Association (10/17/25)
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  • Tidelands Health (Myrtle Beach, SC)
    …people live better lives through better health!** **Supervisor Provider Coding Specialist ** Are you passionate about quality and committed to excellence? Consider ... mission to life each day. **A Brief Overview** The Supervisor, Provider Coding Specialist under the general supervision of the Coding Manager, is responsible for… more
    DirectEmployers Association (10/01/25)
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  • WesleyLife (Pella, IA)
    …growth and purpose. Come be a part of the revolution! ? **About the Role: MDS Specialist ** As a MDS Specialist , you'll play a key role in supporting the health, ... experience of the residents at WesleyLife **As a MDS Specialist , you will:** + Serve as a Clinical Resource...the state RAI's according to mandated timetable. + Follow Medicare guidelines to complete MDS assessments for skilled residents… more
    DirectEmployers Association (11/15/25)
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  • Commonwealth Care Alliance (Boston, MA)
    011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and ... regulatory compliance, and supporting operational excellence to enhance provider satisfaction and member access to care. Reporting to the Senior , Director of… more
    DirectEmployers Association (10/17/25)
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  • Commonwealth Care Alliance (Boston, MA)
    011230 CA-Provider Engagement & Performance **Position Summary** The Provider Relations Liaison is responsible for cultivating, maintaining and strengthening ... provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including… more
    DirectEmployers Association (10/18/25)
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  • Medicare Member Engagement

    Molina Healthcare (Warren, MI)
    …issues or questions. + Log all contacts in a database. + Participate in Member engagement work groups as needed to ensure Medicare member needs are being ... **Job Description** **Job Summary** Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member more
    Molina Healthcare (11/13/25)
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  • Medicare /Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider … more
    Commonwealth Care Alliance (08/31/25)
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  • CISC Member , Caregiver and Stakeholder…

    Magellan Health Services (Albuquerque, NM)
    …Presents the program and offerings in group settings. Consistently achieves member engagement strategies while meeting quality performance standards. + ... with individuals with adverse childhood experiences. General Job Information Title CISC Member , Caregiver and Stakeholder Engagement Manager Grade 23 Work… more
    Magellan Health Services (09/18/25)
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  • Community Resource Center Specialist III

    LA Care Health Plan (Panorama City, CA)
    …data to inform management with an integrated approach to outreach activities and targeted member engagement . Plan, develop, analyze and implement member and ... Community Resource Center Specialist III Job Category: Customer Service Department: Community...instructors. The role leads community and provider outreach and engagement initiatives to increase member traffic at… more
    LA Care Health Plan (11/05/25)
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  • Case Management Specialist

    CVS Health (Harrisburg, PA)
    …to meet performance and productivity metrics, including call volume, successful member engagement , and state/federal regulatory requirements. + **Professional ... every day. **Job Purpose and Summary** As an essential member of our Special Needs Plan (SNP) care team,...Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the… more
    CVS Health (11/20/25)
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