NewOperations Analyst – ECR Inquiry & Dispute Intake ZelisOperations Analyst – ECR Inquiry & Dispute IntakeBoston, MassachusettsThis role serves as the primary operational owner of the inquiry and dispute intake process, ensuring work is accurately categorized, prioritized, and routed to the appropriate teams while supporting client service level agreements (SLAs) and operational excellence. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Principal Machine Learning Engineer, Foundation Models Cambridge Mobile TelematicsPrincipal Machine Learning Engineer, Foundation ModelsCambridge, MA$177,000–$221,300 / yearPioneer advanced self-supervised learning techniques, including the design and implementation of innovative tasks tailored to multi-modal telematics sensor data to learn rich representations of movement and driver behavior. Experience building and maintaining large-scale data processing pipelines and machine learning infrastructure using tools like Spark, Airflow, Docker, and cloud platforms (e.g., AWS, GCP, Azure).
Project Manager II, Construction Administration Massachusetts School Building AuthorityProject Manager II, Construction AdministrationBoston, Massachusetts$86,267–$94,893 / yearLead on specific initiatives assigned by the Senior Project Manager that improve MSBA processes and implement best practices for school building, from the quality and cost-effectiveness of construction to long-term durability and sustainability. Manage project schedules, budgets, cost estimates and scope to ensure compliance with MSBA guidelines and funding agreements while tracking project-specific events, costs and construction developments.
Senior EDI Developer Brigham and Women's HospitalSenior EDI DeveloperSomerville, MA$93,953.60–$136,739.20 / yearMGB Health Plan is seeking an experienced EDI Developer responsible for the design, development, implementation, and ongoing maintenance of healthcare EDI solutions supporting HIPAA transactions, including but not limited to 270/271, 276/277, 278, 820, 834, 835, 837, and 999. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
Manager of Clinical Appeals and Grievances HealthfirstManager of Clinical Appeals and GrievancesMA$103,400–$149,430 / yearProvides guidance in the preparation of case preparation for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
New Hampshire Licensed Pharmacy Technician - Prior Authorizations Shields Health SolutionsNew Hampshire Licensed Pharmacy Technician - Prior AuthorizationsManchester, NHRemote$20–$22 / hourKeywords: Remote Pharmacy Technician, Certified Pharmacy Technician, PTCB, NHA, Medication Access, Prior Authorization, Patient Support, Pharmacy Insurance, Specialty Pharmacy, Financial Assistance, Pharmacy Operations, Medication Adherence, Healthcare Customer Service, Remote Healthcare Jobs, New Hampshire Pharmacy Technician License. Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms.
Assistant Project Manager, Construction Administration Massachusetts School Building AuthorityAssistant Project Manager, Construction AdministrationBoston, Massachusetts$64,814–$71,295 / weekAs part of a small team in a quasi-independent state agency, the Assistant Project Manager contributes to the team’s success by assisting project managers in support of their projects through each phase of the capital pipeline process, and the MSBA’s mission of partnering with school districts to build the best schools possible for Massachusetts students. The Assistant Project Manager works with a motivated team reporting to a Project Manager IIIto accomplish the vital function of monitoring the scope, schedule and budget of Massachusetts public school projects while assisting in the day-to-day management of these projects.
Medical Program Auditor/ Analyst University of Massachusetts Medical SchoolMedical Program Auditor/ AnalystWestborough, Massachusetts4-6 years of related experience in the healthcare industry, business, with at least two years of experience conducting data mining in the healthcare insurance industry, healthcare claim audits, administrative medical record reviews or other claims analysis related experience. Overview: Under the general direction of the Associate Director or designee, the Fraud, Waste, and Abuse (FWA) Auditor serves a crucial role in identifying, investigating, and preventing fraud, waste and abuse for Medicaid programs.
Coordinator 2 - Arbitration MaximusCoordinator 2 - ArbitrationBoston, MAFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net).
Senior Customer Engagement Manager InstabaseSenior Customer Engagement ManagerBoston, MARemote$166,500–$185,000 / yearCollaborating closely with Solution Engineering, Product, and Sales leadership, you will secure the long-term commercial health of our accounts, directly influence the Instabase product roadmap, and help mentor and scale our growing US Customer Engagement practice. Value-Driven Commercial Mindset : Experience in post-implementation value tracking (e.g., defining ROI, throughput gains, and cost-of-service reductions) to ensure deep organizational adoption and identify new operational areas that can benefit from automation.
Manager EH&S Stanley Black & DeckerManager EH&SHolliston, MassachusettsJoin our top-notch team of approximately 43,000 diverse and high-performing professionals globally who are making their mark on some of the world’s most beloved brands, including DEWALT®, BLACK+DECKER®, CRAFTSMAN®, STANLEY®, CUB CADET®, and HUSTLER®. Our lifelong learning philosophy means you’ll have access to a wealth of state-of-the-art learning resources, including our Lean Academy and online university (where you can get certificates and specializations from renowned colleges and universities).
Manager Eh&S Stanley Black & Decker, Inc.Manager Eh&SHolliston, MA$95,600–$153,900 / yearJoin our top-notch team of approximately 43,000 diverse and high-performing professionals globally who are making their mark on some of the world's most beloved brands, including DEWALT, BLACK+DECKER, CRAFTSMAN, STANLEY, CUB CADET, and HUSTLER. Learning & Development: Our lifelong learning philosophy means you'll have access to a wealth of state-of-the-art learning resources, including our Lean Academy and online university (where you can get certificates and specializations from renowned colleges and universities).
Director, Hospital/Professional Billing & Follow Up Mass General BrighamDirector, Hospital/Professional Billing & Follow UpSomerville, MassachusettsExperience : Hospital patient accounts, hospital finance or related revenue cycle operations 3-5 years required and Management experience in Hospital patient accounts, hospital finance or related revenue cycle operations 3-5 years required and EPIC revenue cycle application experience 3-5 years required. In partnership with key stakeholders, the Director, HB/PB Billing & Follow-Up, operationalizes the strategic direction for Patient Financial Services and continuously works to improve staff, processes, and technology approaches across the functions.
Assistant General Counsel for Health Plan Operations Devoted Health ServicesAssistant General Counsel for Health Plan OperationsMassachusettsRemoteThis individual-contributor role reports to the Deputy General Counsel and supports claims, network development and management, provider contracting, delegated entity oversight, and regulatory compliance, translating a complex and evolving legal landscape into actionable guidance for business and clinical teams. The Assistant General Counsel for Health Plan Operations serves as a key legal partner to Devoted’s health plan operations, providing practical, business-minded counsel across the full range of activities that keep our Medicare Advantage and related products running.
Prior Authorization Technician - Pharmacy Technician Shields Health SolutionsPrior Authorization Technician - Pharmacy TechnicianStoughton, MASolid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. If the candidate lives in a state that does not require registration (i.e. Delaware, Hawaii, New York), candidate agrees to obtain a state license withing 6 months of employment and must be nationally certified (PTCB or NHA) at time of hire.
Director of Revenue Cycle Management Overstory HealthDirector of Revenue Cycle ManagementBoston, MAFluency in RCM terminology and workflows (claims, VOB/eligibility, payment posting, AR follow-up, denials management) paired with the ability to communicate clearly with non-billing stakeholders across the business. Overstory Health is a newly launched startup building world-class, patient-centric Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs for individuals with high-acuity mental health needs.
NewRestoration Operations Manager SERVPRO Team JRFRestoration Operations ManagerManchester, NHFull timeThe Operations Manager will dedicate approximately 4–6 hours per week to proactive business development with the following target segments: Property Management Companies: Build preferred-vendor relationships with regional PM firms managing commercial and multi-family portfolios in the Team JRF NH franchise territories. The Restoration Operations Manager is directly responsible for tracking, analyzing, and driving improvement on all mitigation KPMs, including: Revenue per job: Monitor and improve average revenue per mitigation job through proper scoping, documentation, and supplements.
Senior Loss Control Consultant BerkleySenior Loss Control ConsultantMarlborough, MassachusettsBerkley Corporation (NYSE: WRB), one of the largest property casualty insurance holding companies in the United States, our financial strength and integrity are two of the main reasons why Independent Agents place business with us. Develops client-related service plans based on needs analysis and assists the client with problem resolution, policy and procedure development and solution implementation.
Insurance Account Representative (Personal Lines) Keturah KonstellationsInsurance Account Representative (Personal Lines)MassachusettsReview client accounts at renewal time and proactively remarket accounts to find the best coverage options and pricing. This role assists clients with selecting, purchasing, and managing personal insurance policies to ensure adequate coverage and protection.
Commercial Auto Adjuster Safety Insurance Group, Inc.Commercial Auto AdjusterBoston, MAThe adjuster sets up the claim, investigates the accident or loss, determines coverage applicability or exclusions, makes a liability and deductible decision, applies the appropriate surcharge when applicable and processes payments of both direct and subrogation claims. Conveniently located in the heart of Boston's financial district, our downtown office is a positive space where employees can stay connected to both each other and the pulse of the city.