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Highly developed communication & analytic skills. Independent self started motivated to create and deliver opportunities that contribute to CCA's goals. Ability to create, develop and structure information to influence and guide decision making. Interpersonal savvy, detail oriented and strong organizational and listening abilities. Demonstrated networking, delegation and diplomacy skills. Must be
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Why This Role is Important to Us The Vice President for Provider Network Strategy and Contracting RI (the VP) is responsible for building and maintaining a provider network aligned with the strategic growth objectives of the organization. Reporting to the General Manager, Health Plans, the VP leads Provider Contracting and Provider Relations. The VP leads the execution of reimbursement strategie
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Why This Role is Important to Us The CCA Information Technology organization is seeking a VP, Technology Strategy responsible for the planning and execution of its long term transformational technology initiatives. This newly created position will serve as a key member of the technology senior leadership team and report directly to the Chief Information Officer. The objective of this role is to
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Why This Role is Important to Us The CCA Information Technology organization is seeking a VP, IT Governance and Cyber Security. This newly created position will serve as a key member of the technology senior leadership team and report directly to the Chief Information Officer and will be responsible for governance of all IT assets and the cyber security program. The objective of this role is to
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Why This Role is Important to Us Reporting to the Vice President of Medical Policy and Utilization Review, the Director, Medical Utilization Review will be responsible for providing leadership and subject matter expertise to our utilization management group. This role is a key role in helping our organization provide high quality, equitable care to our rapidly growing membership. The incumbent w
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Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day to day timel
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Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day to day timel
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Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day to day timel
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Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Care Partner is primarily responsible for providing longitudinal care coordination and care management to a dedicated panel of dually eligible CCA members, a group of individuals with significant medical, behavioral, and social complexities that require intensive clinical support. The Care Partner provides, care management, and
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A. Independence of action, authority and decisionmaking Researches and identifies new opportunities to improve ITcommunications. Works with IT leaders to set agenda, drive meetings, and coordinate actionitems. B. Accountability scope andimpact Accountable for delivering IT dashboards for theenterprise. Responsible for IT communications within IT, across business units, and with variousvendors. Re
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Adhere to all applicable compliance requirements and the Code of Conduct. Secondary Responsibilities Day to day activities within guidelines Influence operational priorities Low to medium degree of authority Execution of day to day activities Solid functional expertise Emerging management skills
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What We're Looking For Description Actual Work Location 30 Winter Place, Boston, Massachusetts 02108 All Locations 30 Winter Street Exempt / Not Exempt Non Exempt
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Why This Role is Important to Us The Strategic Finance Associate will be a key contributor in CCA's next leg of mission driven growth. The Associate will immediately become an important contributor, helping to drive forward a range of fast paced, external facing projects. There are three primary components of the role Business development exploring & evaluating various avenues to catalyze members
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Why This Role is Important to Us This position is for a Sr Medical Claims Auditor, you will be responsible for identifying and validating medical insurance claim overpayments through data mining efforts and research. You will be an established professional with experience is a senior level position demonstrating proficiency in the practice of healthcare audit services. Responsible for activities
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Why This Role is Important to Us The Server Administrator Level I works in conjunction with the Sr. Systems Administrator and shares responsibility for the specification, selection, installation, configuration, system management, and operation of all server hardware and software for the Commonwealth Care Alliance/Commonwealth Community Care. The Server Administrator Level I works as part of the
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