Care Management Associate, Engagement Hub CVS Health CorpCare Management Associate, Engagement HubMA$18.50–$31.72 / hourStrong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures). Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members' needs and create behavioral change.
Denials Liaison Mass General BrighamDenials LiaisonSomerville, Massachusetts$63,648–$92,570.40 / yearThe Denials Liaison is responsible for analysis, interpretation, and identification of insurance denials performance variations and opportunities; recommending process/system improvement initiatives and implementing those initiatives in collaboration with assigned entity Revenue Directors/denials teams. Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission.
Surgical Services Coordinator II - New England Eye Center - Boston Tufts MedicineSurgical Services Coordinator II - New England Eye Center - BostonBoston, MA$21.53–$26.91 / hourThis position monitors and coordinates all surgical scheduling functions for the department, including answering patient inquiries, initial patient interviews, scheduling and facilitating surgical dates with patients and families or other support systems as noted, assuring surgeon preferences regarding surgical sites, assistants, processes and any additional materials necessary to properly support specific resources. In addition, this role focuses on performing the following General Administration duties: Produces documents, collects, records, sorts and files information, handles mail, prepares routine reports, makes travel arrangements, arranges appointments, responds to inquiries, data entry, and operates office equipment.
Medical Records Director Non Nurse/HIM Temporary Life Care Centers of America IncMedical Records Director Non Nurse/HIM TemporaryBillerica, MACredentialed as a Registered Health Information Administrator (RHIA) OR as a Registered Health Information Technician (RHIT) OR have a degree in a health related field with extensive training and demonstrated competence in the HIM field. Perform proficiently in all competency areas including but not limited to: medical coding, auditing, clinical records, privacy official responsibilities, supervisory responsibilities, patient rights, and safety and sanitation.
Senior Clinical Data Manager Repertoire Immune MedicinesSenior Clinical Data ManagerCambridge, MAFull timeThis individual will provide hands-on data management expertise and sponsor oversight of CROs and third-party vendors, partnering closely with Clinical Operations, Clinical Development, Safety, Regulatory, Translational Medicine, and external vendors to ensure timely, accurate, complete, and inspection-ready clinical trial data in accordance with GCP, ICH guidelines, applicable regulatory requirements, data privacy requirements, and Repertoire SOPs. Trial Leadership & Data Management Develop and maintain key data management documents, including the Data Management Plan, eCRF specifications, completion guidelines, edit check specifications, data validation plan, data transfer specifications, external data reconciliation plans, medical coding plan, and database lock plan.
Computational Scientist, Protein Engineering Manifold Bio IncComputational Scientist, Protein EngineeringBoston, MA$118,000–$138,000 / yearManifold Bio is a platform biotechnology company pioneering AI-guided protein design and massively multiplexed in vivo screening to unlock tissue-targeted medicines and organism-scale models of living systems. Using proprietary molecular barcoding technology, we screen hundreds of thousands of protein designs simultaneously in living systems, producing in vivo-validated datasets at a scale no one else can match.
Surgical Services Coordinator II - New England Eye Center - Boston Lowell General HospitalSurgical Services Coordinator II - New England Eye Center - BostonBoston, MA$21.53–$26.91 / hourThis position monitors and coordinates all surgical scheduling functions for the department, including answering patient inquiries, initial patient interviews, scheduling and facilitating surgical dates with patients and families or other support systems as noted, assuring surgeon preferences regarding surgical sites, assistants, processes and any additional materials necessary to properly support specific resources. In addition, this role focuses on performing the following General Administration duties: Produces documents, collects, records, sorts and files information, handles mail, prepares routine reports, makes travel arrangements, arranges appointments, responds to inquiries, data entry, and operates office equipment.
IBR Senior Analyst Zelis Healthcare, Inc.IBR Senior AnalystMA$79,000–$99,750 / yearThis 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. The Itemized Bill Review Senior Analyst will be responsible for analyzing hospital claims for adherence to proper billing guidelines and will work closely with Expert Claims Review staff to efficiently adhere to policies and procedures for claims processing.
NewNational Sales Director, D-PLEX100 – US Institutional Sales (Surgical Business Unit) Azurity Pharmaceuticals - USNational Sales Director, D-PLEX100 – US Institutional Sales (Surgical Business Unit)Woburn, MARemoteThe Sales Force Director designs the sales model and deployment, recruits and hires the field team and its management layer, builds the training and onboarding program, and leads day-to-day sales execution across US hospitals and surgical facilities. The ideal candidate brings a minimum of 12 years in pharmaceutical or biotech, including significant hospital/institutional field sales experience and a proven record of building and leading field sales teams (first- and second-line leadership).
Audit Coordinator Lahey Hospital and Medical CenterAudit CoordinatorMA$20–$26.92 / hourActual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.
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.
Care Facilitator - Behavioral Health UnitedHealth Group IncCare Facilitator - Behavioral HealthQuincy, MAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. This role supports coordinated patient‑centered care for at‑risk individuals by facilitating care plans monitoring adherence and serving as a key liaison between primary care behavioral health teams and patients or their families.
Director of Behavioral Health for Community Health Centers Harbor Health Services IncDirector of Behavioral Health for Community Health CentersMAAssesses patient and community needs and develops proposals for service expansion and new treatment modalities (e.g., group services, psychological testing, short-term therapy), including the growth and management of SUD and other Behavioral Health programs to enhance patient care and better serve the community. Provides administrative supervision for all HHSI CHC Behavioral Health staff in coordination with the Operations Department, including scheduling, ensuring appropriate staffing levels and coverage, facilitating staff meetings, and serving as a liaison between Behavioral Health and other HHSI departments.
Clinical Documentation Specialist Quincy Physician Administrative ServicesClinical Documentation SpecialistQuincy, MaineWorking collaboratively with providers, clinical leaders, coding professionals, and operational teams, you will identify opportunities for documentation improvement, provide individualized education, and help implement best practices that enhance the accuracy and completeness of the medical record. As a Clinical Documentation Specialist at Quincy Medical Group, you will play a key role in advancing our Value-Based Care initiatives by partnering with providers to improve clinical documentation, diagnosis capture, and coding accuracy.
NewClaims Analyst Pharmacy Revenue Cycle GTT, LLCClaims Analyst Pharmacy Revenue CycleBoston, MAUnder the direction of the Revenue Cycle Supervisor Pharmacy, the Revenue Cycle Claims Analyst is responsible through extensive telephone and written correspondence, will pursue insurance companies for payment or underpayment of services rendered. Improving performance requires fine-tuned workflows, training, dedicated resources, collaboration across multiple departments, and routine updates to core systems.
Medical Director MPO CVS Health CorpMedical Director MPOMA$174,070–$374,920 / yearIn this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. Additional responsibilities may include: Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services.
Registered Nurse (MNA) Internal Medicine Atrius Health Dedham UnitedHealth Group IncRegistered Nurse (MNA) Internal Medicine Atrius Health DedhamDedham, MAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Licensed Practical Nurse Internal Medicine Atrius Health Dedham UnitedHealth Group IncLicensed Practical Nurse Internal Medicine Atrius Health DedhamDedham, MAMaintains patient confidentiality Under established protocols or under specific clinician direction communicates with patients or family regarding specific test results or follow-up plans Proficient in medication administration via IM sc ID and nebulizer routes Maintains proficiencies in role specific procedures as defined in organizational LPN competencies Participates in organizational and departmental process improvement activities Participate in emergency procedures Provides exceptional service to patients families and other staff members Performs other duties as assigned. Informs RN or clinician of IVs that need mixing Documents all patient care activities observations actions and patient outcomes in electronic patient medical records within the established organizational timeframe Explains procedures to patients to facilitate understanding Performs the necessary set-up for examinations and procedures available to support the clinician and patient Communicates any pertinent information to the relevant members of the health care team verbally andor through medical record.
Per Diem Radiology Technologist - Atrius Health UnitedHealth Group IncPer Diem Radiology Technologist - Atrius HealthNorwood, MAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Were an innovative health care leader and multi-specialty group practice delivering an effective connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts.
Social Worker UnitedHealth Group IncSocial WorkerBeverly, MAClinical › Corporate and business operations › Customer and support services › Early careers › Sales and account management › Technology and data › Physicians › Advanced practice clinicians › Pharmacy › Behavioral health › Nursing › Medical coding › Clinical support › U.S. › Ireland & UK › India › Philippines › Culture of Belonging › Employee Benefits › Blog. From clinical operations such as credentialing to business operations such as contracting we provide organizational support that allows our providers to focus on what matters - providing care.