Payment Integrity Program Development Manager Devoted Health ServicesPayment Integrity Program Development ManagerMassachusettsRemoteThat’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. (Note: We provide modern AI tools to generate and edit SQL scripts; you do not need to be a software expert, but you must possess the ability to read, interpret, and understand data scripts to validate results and analyze proof-of-concept datasets).
NewSenior EDI Developer Mass General BrighamSenior EDI DeveloperSomerville, Massachusetts$93,953.60–$136,739.20 / yearData analysis entails understanding the flow of data and its interdependency among QNXT core modules such as Member-Enrollment and Services, Claims Processing, Provider Relations, Clinical Systems and Finance.-Track and monitor problem tickets to insure timely resolution-Communicate status and escalate issues as needed.-Identify and resolve problems related to business processes and applications.-Coordinate and/or perform change and revision management to ensure inter-operability of systems -Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.-Assist in requirements gathering with end users to clearly define information needs and translate those requirements into specifications for development.-Participate in change management, disaster recovery and production support operations.-Coordinate technical support and software upgrades with in-house staff and outside vendors to ensure NHP applications are performing effectively. Primary Responsibilities:-Programming, including writing T-SQL in SQL Server and SSIS packages, which support the Vendor Interfaces.-Analyze business and system requirements, including impact analyses on existing systems, to develop systems specifications-In partnership with the business units, design, prepare and execute unit test plans for application upgrades and enhancements.-General data mapping of ANSI HIPAA EDI files, including coding, translation, development, testing and deployment or EDI applications.-Perform analysis on systems and processes to become a subject matter expert, in order to help and support the business units.-Work with hosted vendors to accomplish SDLC objectives-Provide data analysis support for NHP business areas in order to assist with the business areas’ information, reporting and application development needs.-
IT Project Coordinator- REMOTE Sierra Solutions GroupIT Project Coordinator- REMOTEBoston, MARemoteSoft Skills: Exceptional organizational skills and the ability to "translate " technical jargon into plain language for non-technical business partners. Risk & Issue Tracking: Maintain the RAID (Risks, Actions, Issues, and Decisions) log, ensuring that technical roadblocks are escalated promptly.
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).
Senior Software Engineer - RPA V2 LiveDataSenior Software Engineer - RPA V2Cambridge, MARemote$145,000–$175,000 / yearOur immediate focus is new automation interfaces to Oracle Health/Cerner; you will own the lifecycle from process discovery through implementation, developing automation code with extensive use of modern AI development tools, while collaborating with DevOps on deployment and operational support. You will work directly with clinical stakeholders to understand and automate complex workflows, turning loosely defined processes into reliable automation using sound engineering judgment.
Senior Software Engineer, Billing Workflows - Athenacollector Athenahealth inc.Senior 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.
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 Configuration Services (44064) Neighborhood Health Plan of Rhode IslandManager Of Configuration Services (44064)Smithfield, RIManages the Configuration Services duties including but not limited to, review of requirements, oversight of usecase and documentation creation, analysis of inventory to support the prioritization of corporate issues. Work closely with Manager of Business Solutions, Project Managers, the Production Support Manager to ensure compliance to the System Development Life Cycle (SDLC) and the change approval process.
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.
Director, Patient Access Liaison - East Intellia TherapeuticsDirector, Patient Access Liaison - EastCambridge, MA$225,000–$275,000 / yearAbout You: The Director of Patient Access Liaisons is a field-based leadership role responsible for building, developing, and managing a high-performing team of Patient Access Liaisons who support providers, care teams, and patients in navigating reimbursement and overcoming access obstacles for lonvo-z. This role serves as the operational backbone of the patient access function-translating strategy into execution, ensuring consistent field excellence, and delivering insights that strengthen the broader market access and launch strategy.
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.
Lead Analyst, Channel Systems & Projects Analog DevicesLead Analyst, Channel Systems & ProjectsWilmington, MassachusettsOwn Model N 2.0 initiatives across channel design registrations, claims, POS, and inventory — speeding turnaround to distributors, reducing internal workload, and fully utilizing Model N functionality, including: Automating Negative Claims submissions, POS & Inventory processing, price bucket sync, and inventory reconciliation. ADI combines analog, digital, AI, and software technologies into solutions that combat climate change, reliably connect humans and the world, and help drive advancements in automation and robotics, mobility, healthcare, energy and data centers.
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.
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).
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.
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.
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.
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.
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).