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Commonwealth Care Alliance
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Boston, Massachusetts
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direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery ... processes.
Identify overpayment/underpayment opportunities by data mining, investigation, and quality
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Commonwealth Care Alliance
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Boston, Massachusetts
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direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr ... forecasting for small to large Operations Management
Collaborate system and data configuration into CES
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Commonwealth Care Alliance
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Boston, Massachusetts
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contributor role. Working under the direction of the Sr. Director, TPA Management and Claims Compliance ... necessary due to regulatory changes, contractual changes, or because of data findings. The Policy Manager
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Commonwealth Care Alliance
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Boston, Massachusetts
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(SIU). The position reports directly to the Sr. Director, Fraud, Waste & Abuse. This position utilizes ... investigation, and coordinate with management recommendations and further actions and/or resolutions
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Commonwealth Care Alliance
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Boston, Massachusetts
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Why This Role is Important to Us:
Position Summary:
Reporting to the Director ... effective professional work relationships, working collaboratively with all levels of management and
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Commonwealth Care Alliance
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Boston, Massachusetts
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skills managing data in Oracle Relational Database Management Systems (RDBMS)
Basic knowledge of the ... Why This Role is Important to Us:
The Workforce Management Supervisor is responsible for
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Commonwealth Care Alliance
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Boston, Massachusetts
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management, care coordination, and care delivery. The Clinical Manager will ensure that the team meets ... for providing longitudinal care coordination, care management, and care delivery to a
dedicated
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Commonwealth Care Alliance
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Boston, Massachusetts
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data) to identify accurate, successful contact information for unreachable or hard-to-reach members ... they transition to CCA through healthcare provider outreach and education
Schedules new members
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Commonwealth Care Alliance
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Boston, Massachusetts
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payment integrity, pricing, editing, and encounter submission.
Provider Data Management
Strong knowledge of healthcare payer provider processes, supporting systems, and data including
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Commonwealth Care Alliance
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Boston, Massachusetts
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payment integrity, pricing, editing, and encounter submission.
Provider Data Management
Strong knowledge of healthcare payer provider processes, supporting systems, and data including
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Commonwealth Care Alliance
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Boston, Massachusetts
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Compliance team to report any and all necessary data to regulators and/or management as appropriate or ... access to their data.
Leads CCA records retention and management program, partnering with all
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Commonwealth Care Alliance
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Boston, Massachusetts
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Why This Role is Important to Us:
Under direction of the Director of Internal Audit, the ... transparent communication with auditees, management, and stakeholders; preparing interim and final reports
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Commonwealth Care Alliance
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Boston, Massachusetts
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, and encounter submission.
Provider Data Management
Strong knowledge of healthcare payer provider processes, supporting systems, and data including credentialling, contracting, directory
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Commonwealth Care Alliance
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Boston, Massachusetts
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triage member phone calls to accurately route to appropriate area.
Work with care management team to ... members with any requested documents including provider listings in their areas.
Complete
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Commonwealth Care Alliance
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Farmington Hills, Michigan
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Why This Role is Important to Us
CCA is seeking a senior director to lead the performance of our ... on supporting providers with actionable insights to improve patient outcomes.
The senior director
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Commonwealth Care Alliance
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Boston, Massachusetts
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competency in documenting pertinent patient data in the medical record consistent with CCA expectations ... .
Utilizes quality improvement data to enhance patient care.
Provide clinical care to members via
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Commonwealth Care Alliance
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Boston, Massachusetts
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pathways to housing and jobs as well as linguistically and culturally appropriate case management and nurse ... provides management oversight for a number of family shelter sites, providing direct supervision for Site
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Commonwealth Care Alliance
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Boston, Massachusetts
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pathways to housing and jobs as well as linguistically and culturally appropriate case management and nurse ... provides management oversight for a number of family shelter sites, providing direct supervision for Site
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Commonwealth Care Alliance
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Boston, Massachusetts
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. This individual leverages the Minimum Data Set (MDS) assessment and develops and documents person-centered care plan using data collected during the assessment process. This individual works
...
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Commonwealth Care Alliance
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Boston, Massachusetts
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. This individual leverages the Minimum Data Set (MDS) assessment and develops and documents person-centered care plan using data collected during the assessment process. This individual works
...
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Commonwealth Care Alliance
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Boston, Massachusetts
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. This individual leverages the Minimum Data Set (MDS) assessment and develops and documents person-centered care plan using data collected during the assessment process. This individual works
...
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Commonwealth Care Alliance
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Boston, Massachusetts
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. This individual leverages the Minimum Data Set (MDS) assessment and develops and documents person-centered care plan using data collected during the assessment process. This individual works
...
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Commonwealth Care Alliance
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Boston, Massachusetts
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. This individual leverages the Minimum Data Set (MDS) assessment and develops and documents person-centered care plan using data collected during the assessment process. This individual works
...
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Commonwealth Care Alliance
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Boston, Massachusetts
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. This individual leverages the Minimum Data Set (MDS) assessment and develops and documents person-centered care plan using data collected during the assessment process. This individual works
...
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Commonwealth Care Alliance
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Boston, Massachusetts
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Medicare and EOHHS?s Complaints Tracking & Management (CTM) Module and timely communication of next steps ... analyzing complaint trends and presenting this data within CCA.
Assist in the update of CCA’s
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Commonwealth Care Alliance
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Boston, Massachusetts
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partners provide linguistically and culturally appropriate case management and nurse triage support ... performance management program for housing navigation efforts across CCA's shelter sites, and serve as an
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Commonwealth Care Alliance
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Boston, Massachusetts
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support of CCA software applications and software data integrations.
The Senior Software Engineer is responsible for the development and maintenance of data processes and applications designed to
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Commonwealth Care Alliance
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Boston, Massachusetts
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support of CCA software applications and software data integrations.
The Senior Salesforce ... , technological sophistication, reliability in handling complex data, and large user base. Integration between and
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Commonwealth Care Alliance
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Boston, Massachusetts
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partners provide linguistically and culturally appropriate case management and nurse triage support ... performance management program for housing navigation efforts across CCA's shelter sites, and serve as an
...
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Commonwealth Care Alliance
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Boston, Massachusetts
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partners provide linguistically and culturally appropriate case management and nurse triage support ... performance management program for housing navigation efforts across CCA's shelter sites, and serve as an
...
