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Massachusetts and Rhode Island Market Medical Director (Board Certified Geriatri
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us Reporting to the Health Plan Chief Medical Officer (CMO), the Massachusetts and Rhode Island Market Medical Director is an integral part of a mission driven clinical and market team. The Medical Director's primary responsibilities are to ensure that the clinical processes that contribute to the Massachusetts Duals (SCO/OneCare) and RI DSNP
Email Job
Posted 12 days ago
Utilization Management Nurse Reviewer (RN) - Remote in MA
Commonwealth Care Alliance
-
Boston, MA
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 responsi
Email Job
Posted 13 days ago
Provider Relations Liaison (Temporary)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us The Provider Relations Specialist is responsible for cultivating, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including primary care practices, sp
Email Job
Posted 13 days ago
Utilization Management Nurse Reviewer (RN) - Remote
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us 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 CMS compliance standards in the area of service decisions and organizational determinations.
Email Job
Posted 13 days ago
Manager, Mail Operations (on-site)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us This is a key leadership role that will provide oversight of CCA's multi state Mail Operations. The Mail Operations Manager is responsible for being CCA's subject matter expert for all postage and mailing activities. The Mail Operations Manager ensures compliance with business requirements and with all US Postal Service regulations on post
Email Job
Posted 16 days ago
FDR Compliance Analyst (Remote)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us Under direction of the Compliance Manager, , the primary focus of this position is the day to day coordination of oversight activities for CCA's First Tier, Downstream, Related Entities (FDR) and Medicaid Material Subcontractors (MS), also known as the FDR MS Program. This includes review of contract and policy documents, coordinating atte
Email Job
Posted 16 days ago
Executive Assistant
Commonwealth Care Alliance
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Boston, MA
Why This Role is Important to Us The Executive Administrator will serve as a critical contributor to the workings of the Chief Revenue and Growth officer and his direct reports including the connection and management of many critical components of the organization. In addition, the Executive Administrator will support the General Manager, Market Lead Massachusetts. What Y
Email Job
Posted 17 days ago
Manager, Privacy (Remote)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us The Manager, Privacy will play a key role in building, operationalizing and sustaining an effective and robust Privacy Program. Reporting to the Director, the role will ensure that the organization complies with relevant and applicable privacy laws, regulations, contractual requirements, and standards. The role will be responsible for deve
Email Job
Posted 17 days ago
Director, Privacy (Remote)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us The Director, Privacy will play a key role in building, operationalizing and sustaining an effective and robust Privacy Program. Reporting to the Chief Privacy Officer, the role will ensure that the organization complies with relevant and applicable privacy laws, regulations, contractual requirements, and standards. The role will be respon
Email Job
Posted 17 days ago
Senior Product Owner (Ancillary & Pharmacy IT)(Remote)
Commonwealth Care Alliance
-
Boston, MA
Support IT communications Review documentation and provide feedback on quality and accuracy Research new ways to conduct business operations Research new technologies and its applicability Provide ideas to resolve risks and issues to IT leadership team Participate in learning and development Maintain active career development plan What We're Looking For Education Bachelor
Email Job
Posted 24 days ago
IT Portfolio Manager of Ancillary & Pharmacy Services (Remote)
Commonwealth Care Alliance
-
Boston, MA
Develop and maintain relationships with IT, business units and vendors to identify potential opportunities (projects and programs) to improve business operations, and deliver business outcomes. Consult with business unit's and review IT usage, services, technology, and department specific projects. Identify, forecast and develop IT needs. Establish subject matter expertis
Email Job
Posted 24 days ago
Nurse Practitioner/Physician Assistant (Springfield Clinic and Virtual Visits fr
Commonwealth Care Alliance
-
Springfield, MA
Why This Role is Important to Us Commonwealth Community Care's (CCC) Primary Care NP/PA provides comprehensive primary care consultation and management to adults of all ages, familiar with those who have complex physical, developmental, intellectual, and behavioral health conditions, requiring medical evaluation and care. Care is delivered in the office, home, and crisis
Email Job
Posted 25 days ago
Nurse Practitioner or Physician Assistant (Springfield Clinic and Virtual Visits
Commonwealth Care Alliance
-
Springfield, MA
Why This Role is Important to Us Commonwealth Community Care's (CCC) Primary Care NP/PA, BOS/SPR provides comprehensive primary care consultation and management to adults of all ages, familiar with those who have complex physical, developmental, intellectual, and behavioral health conditions, requiring medical evaluation and care. Care is delivered in the office, home, an
Email Job
Posted 25 days ago
Palliative Care Nurse Practitioner - Lynn/Salem (32 Hours)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us The Palliative Care NP provides consultative specialty services related to serious illness impacts on members and caregivers and care coordination to a defined panel of CCA member's needs. The panel of members will be comprised of individuals with serious illness and may have significant behavioral, psychosocial and medical complexities th
Email Job
Posted 26 days ago
Primary Care NP/PA - (Revere/Lynn)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us Commonwealth Community Care's (CCC) Primary Care NP/PA provides comprehensive primary care consultation and management to adults of all ages, familiar with those who have complex physical, developmental, intellectual, and behavioral health conditions, requiring medical evaluation and care. Care is delivered in the office, home, and crisis
Email Job
Posted 26 days ago
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