Epic Denials Management Operator DeloitteEpic Denials Management OperatorCincinnati, OH$70,000–$90,000 / yearJoin Deloitte's AI & Engineering practice to support hospital denials management to deliver back-end Revenue Cycle Management (RCM) services, including Billing and Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes.
Associate Director, Pharmacovigilance Scientist Candel Therapeutics IncAssociate Director, Pharmacovigilance ScientistNeedham, MARemote$184,000–$200,000 / yearEssential Areas of Responsibility: The Associate Director, Pharmacovigilance Scientist will be responsible for the following: Perform sponsor review and approval of serious adverse event (SAE) and other individual case safety reports in Argus, including assessment of case completeness, medical consistency, query adequacy, coding accuracy, narrative quality, causality, expectedness, reportability, and required follow-up. Reporting to the Senior Director, Pharmacovigilance and Safety, this individual will contribute to the detection, assessment, understanding, documentation, and prevention of product safety risks by partnering closely with Clinical Development, Clinical Operations, Regulatory Affairs, Data Management, Biostatistics, Medical Writing, Quality, external vendors, and study teams.
Medicaid Risk Adjustment Market Manager CVS Health CorpMedicaid Risk Adjustment Market ManagerMA$54,300–$145,860 / yearPartner with segment product, sales, network, clinical teams to implement processes aimed at strengthening member and provider engagement of Revenue Integrity programs resulting in improved outcomes. This is a high-visibility role responsible for driving market level engagement, delivering insights, and demonstrating the value of Medicaid risk adjustment performance to senior leaders and market partners.
Informatics Consultant CVS Health CorpInformatics ConsultantMA$43,888–$102,081 / year1+ year(s) computer skills and knowledge of Microsoft Word, Excel, PowerPoint and Adobe Acrobat Pro experience with reporting platforms such as: Big data analytics, data mining, and Tableau. Become a subject matter expert for Client Management, clients and brokers related to our internal analytics tool and their client's data.
Director, Patient Access PharmaEssentia U.S.A.Director, Patient AccessBurlington, MA$184,620–$239,700 / yearFounded in 2003 by a team of Taiwanese-American executives and renowned scientists from U.S. biotechnology and pharmaceutical companies, today we are listed on the Taiwan Stock Exchange (TWSE: 6446) and are expanding our global presence with operations in the U.S., Japan, Singapore, South Korea, and China, along with a world-class biologics production facility in Taichung. Position Overview: The Director, Patient Access will serve as the strategic and operational leader for PharmaEssentia’s Patient Access function, with accountability for access strategy, patient support operations, vendor governance, program performance, and continuous improvement across Patient Access Programs.
Associate Director, Pharmacovigilance Scientist Candel TherapeuticsAssociate Director, Pharmacovigilance ScientistNeedham, MA$184,000–$200,000 / yearEssential Areas of Responsibility: The Associate Director, Pharmacovigilance Scientist will be responsible for the following: Perform sponsor review and approval of serious adverse event (SAE) and other individual case safety reports in Argus, including assessment of case completeness, medical consistency, query adequacy, coding accuracy, narrative quality, causality, expectedness, reportability, and required follow-up. Reporting to the Senior Director, Pharmacovigilance and Safety, this individual will contribute to the detection, assessment, understanding, documentation, and prevention of product safety risks by partnering closely with Clinical Development, Clinical Operations, Regulatory Affairs, Data Management, Biostatistics, Medical Writing, Quality, external vendors, and study teams.
VA Primary Care Physician Purposelink RecruitmentVA Primary Care PhysicianMassachusetts, MassachusettsProvide primary care services to Department of Veterans Affairs beneficiaries at the Hyannis VA Outpatient Clinic . Refer patient or customer service issues to the Primary Supervisory Physician or Deputy Chief of Primary Care.
Associate Director, Clinical Sciences - Oncology Moderna IncAssociate Director, Clinical Sciences - OncologyCambridge, MA$158,600–$285,500 / yearWe are proud to have been recognized as a Science Magazine Top Biopharma Employer, a Fast Company Best Workplace for Innovators, and a Great Place to Work in the U.S. If you want to make a difference and join a team that is changing the future of medicine, we invite you to visit modernatx.com/careers to learn more about our current opportunities. Broadly stated, in conjunction with the Clinical Study Lead and the broader Clinical Trial Team, oversee end-to-end delivery of clinical trial protocols including study design, initiation, medical safety data monitoring, data dissemination and closeout activities.
Senior Software Engineer, Billing Workflows - athenaCollector athenahealth IncSenior Software Engineer, Billing Workflows - athenaCollectorBoston, MA$119,000–$203,000 / yearWe offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients - powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. What we can do for you: Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces - some offices even welcome dogs.
Decision Scientist - Clinical Informatics (Clinical Data Standards) CVS Health CorpDecision Scientist - Clinical Informatics (Clinical Data Standards)MA$64,890–$158,620 / yearA&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses. Collaborate with data engineering teams to inform data pipeline development, ensuring clinical data is ingested, transformed, and stored in ways that support downstream analytics needs.
NewAssociate Principal Scientist, PharmaR&D Tempus AIAssociate Principal Scientist, PharmaR&DBoston, Massachusetts$155,000–$200,000 / yearReal World Data Expertise & Technical Oversight: Lead the derivation of complex real-world endpoints using extensive coding, demonstrating deep comprehension of Tempus clinical and molecular data structures and complexity, while also serving as an expert on the methodological nuances and limitations of real-world data. Technical/Scientific Skills: Expert-level proficiency in observational late stage trial data or real-world healthcare data, specifically in designing and implementing complex time-to-event methodologies (survival analysis).
Manager Clinical Data Monte Rosa Therapeutics IncManager Clinical DataBoston, MAThis individual will work closely with Clinical Operations, Biostats and Programming, Medical, Safety, Regulatory, external CROs, and technology vendors to ensure high-quality, inspection-ready clinical data. Manage CROs, EDC vendors, central labs, imaging vendors, eCOA providers, IRT vendors, and other data providers.
Clinical Review Specialist Brigham and Women's HospitalClinical Review SpecialistSomerville, MA$63,648–$92,570.40 / yearThe framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. 2+ years experience with chart reviews in electronic medical records, clinical data, supporting or leading work around quality and improvements and creating and/or presenting education material required.
Nurse Manager - Utilization Management (Full Time) Lahey Hospital and Medical CenterNurse Manager - Utilization Management (Full Time)Burlington, MA$165,000–$215,000 / yearAssigns and reviews staff schedules and workflows and works closely with other administrative and clinical areas under the direction of the Executive Director and the VP of Revenue Cycle/Chief Revenue Officer as part of an integrated Revenue Cycle model. Manages the Utilization Management (UM) team, maintaining effective and efficient processes for determining appropriate patient admission status based on regulatory and reimbursement requirements of various commercial and government payers.
Wound Care Nurse - LPN - Full Time Project RestorixWound Care Nurse - LPN - Full TimeLowell, MAWhat You'll Do: Provide patient care based on scientific principles/nursing theory and evidence-based practiceImplement physician orders accurately within appropriate time framesRecognize change in the patient's condition and intervene appropriatelyPrioritize nursing actions including reflecting patient needs, acuity, and desired outcome. Qualifications: Valid LPN nursing license requiredValid CPR certification from the American Heart Association requiredPrior experience working with wound care patients preferred (Will train)Experience with billing and coding preferred.
Professional Accounts Receivable Specialist - EHS Patient Accounts - Full Time SolutionHealthProfessional Accounts Receivable Specialist - EHS Patient Accounts - Full TimeManchester, New HampshireThe Professional Accounts Receivable (AR) Specialist is responsible for timely and accurate billing, follow-up, and resolution of third-party payer claims including commercial insurance, Medicare, Medicaid, and government-assisted programs. Assist Denial and Payment Variance teams in researching, analyzing, and resolving denied or underpaid claims, including technical and administrative denials, and escalate complex issues when necessary.
Professional Accounts Recievable Specialist - EHS Patient Accounts - Full Time SolutionHealthProfessional Accounts Recievable Specialist - EHS Patient Accounts - Full TimeManchester, New HampshireThe Professional Accounts Receivable (AR) Specialist is responsible for timely and accurate billing, follow-up, and resolution of third-party payer claims including commercial insurance, Medicare, Medicaid, and government-assisted programs. Assist Denial and Payment Variance teams in researching, analyzing, and resolving denied or underpaid claims, including technical and administrative denials, and escalate complex issues when necessary.
Director, Field Market Access Beam Therapeutics IncDirector, Field Market AccessCambridge, MA$210,000–$260,000 / yearBeam's suite of gene editing technologies is anchored by base editing, a proprietary technology that is designed to enable precise, predictable and efficient single base changes, at targeted genomic sequences, without making double-stranded breaks in the DNA. Educate providers on local payer trends, appropriate billing and coding for gene therapy, providing support to offices for individual patient reimbursement journeys, including troubleshooting reimbursement concerns.
NewExecutive Corporate Account Director Karyopharm Therapeutics Inc.Executive Corporate Account DirectorNewton, MassachusettsRole Overview & Key Functions: The Executive Corporate Account Director (Executive CAD), US Payers is a senior market access leader responsible for developing and executing enterprise-level strategies to optimize patient access to Karyopharm products across National Payers, including Commercial and Government accounts, key Regional Payers, Pathway Companies, and targeted Integrated Delivery Networks (IDNs). This individual serves as a recognized subject matter expert and strategic partner to key external customers and provides leadership and influence across Karyopharm’s Market Access, Commercial and cross-functional organizations.
Prior Authorization Specialist - Beverly Lahey Hospital and Medical CenterPrior Authorization Specialist - BeverlyBeverly, MA$20.50–$27.59 / hourCustomer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.