Commonwealth Care Alliance Jobs in United States

Quality Assurance Reviewer Associate I Role Summary · Develop in-depth knowledge of policies and procedures to ensure accurate review of verbal and written communications. · Agregate weekly and monthly review results for Executive-level reports. · Meet standards for completing wo ...

Key Responsibilities: · Manage conflicts of interest, gifts & entertainment, compliance & ethics protocols. · ...

About this opportunity · As part of our commitment to enhancing provider relationships, Commonwealth Care Alliance is seeking an experienced Provider Communications Manager · Main responsibilities: · To manage digital strategies that support effective messaging across various tea ...

Overview · Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 m ...

A nonprofit health organization in Massachusetts is seeking a Clinical Care Manager to provide integrated care management for dually-eligible enrollees. The role requires engaging with members to develop care plans and coordinate services across healthcare providers. Applicants s ...

This position is available to remote employees residing in Massachusetts. · Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary coding configuration requirements for Optum CES and Zelis edits. · Analyze, measure, m ...

The Director of Provider Relations leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines of business. · Demonstrated success building and managing provider partnerships across multiple provider types. · ...

Care Partner Role Summary · The Care Partner provides comprehensive care coordination and management services to Commonwealth Care Alliance members. · Facilitate preventative and primary care as needed. · Provide regular telephonic calls for chronic disease or end-of-life support ...

The Senior Provider Relations Specialist builds · and strengthens relationships with Commonwealth Care Alliance's diverse provider community. · Lead provider servicing activities. · Serve as a primary resource for resolving provider inquiries. · Collaborate in the implementation ...

The Director of Provider Relations leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines of business. · ...

The Virtual Medical Control (VMC) Physician provides medical decision making to patients seen by instED's Mobile Integrated Healthcare service. · ...

The HEDIS Network Analyst will support CCA's ability to meet and surpass critical Quality benchmarks and optimize member outcomes as measured through critical measures. · This role supports efforts of the organization's Network and Provider Contracting department. · Frequently in ...

The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring follow-up and clinical care management to dually-eligible enrollees with complex medical behavioral and social care needs. · ...

Key Responsibilities · The Community Health Worker I supports enrollees to overcome barriers to care and meaningful engagement related to social needs. · Assess and educate enrollees in key areas including food, housing, transportation, benefit maintenance, community resources/pr ...

Why This Role is Important to Us · The Vice President of Customer Experience at instED plays a key part in driving customer adoption across existing and new clients while ensuring high client satisfaction. · What You'll Be Doing · ...

The Provider Delegation Performance Manager is responsible for overseeing and improving the performance of CCA's delegated partnerships programs. · Assume full management responsibility for all performance measure components. · Track and analyze site-level and program-wide KPIs t ...

We are seeking a Clinical Care Manager to join our team. This is an exciting opportunity for a motivated and compassionate individual to make a real difference in the lives of our members. · ...

The BH Provider Engagement Program Manager is responsible for cultivating strong relationships with behavioral health providers and driving performance improvement through data insights and education. · Master's degree in behavioral health discipline or equivalent experience. · 5 ...