Why This Role is Important to Us The Director, Privacy will play a key role in building, operationalizing and sustaining an effective and robust Privacy Program. Reporting to the Chief Privacy Officer, the role will ensure that the organization complies with relevant and applicable privacy laws, regulations, contractual requirements, and standards. The role will be respon

Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible

Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible

Why This Role is Important to Us Supervisor & The Team Leader reports to the UM Manager. The Team Leader provides management,oversight and mentorship to team members and ensures that Team members are meeting quality and productivity standards. The Team Leader works in close collaboration with the manager and Director of the UM team. What You'll Be Doing Provide oversight,

Why This Role is Important to Us The Specialist, Quality Provider Engagement ACO/PO monitors Quality Measures within Accountable Care Organization physicians' offices for Group Practice Reporting Options (GPRO). Conducts onsite reviews and audits for Medicare compliance. This position partners with providers to support in office improvement efforts aimed at increasing the

Why This Role is Important to Us The Provider Contract Manager is responsible for developing, negotiating and managing contractual, legal and financial arrangements with providers that ensure CCA members have superior access to the highest quality, cost effective providers of healthcare services. What You'll Be Doing Develop, negotiate and maintain provider contracts for

Why This Role is Important to Us CCA partners with the Commonwealth of Massachusetts to provide supportive temporary emergency shelter to families under the Executive Office of Housing and Livable Communities' Emergency Assistance program. Our shelter program is part of the Commonwealth's response to a rapidly growing number of unhoused families, including thousands of fa

Support IT communications Review documentation and provide feedback on quality and accuracy Research new ways to conduct business operations Research new technologies and its applicability Provide ideas to resolve risks and issues to IT leadership team Participate in learning and development Maintain active career development plan What We're Looking For Education Bachelor

Develop and maintain relationships with IT, business units and vendors to identify potential opportunities (projects and programs) to improve business operations, and deliver business outcomes. Consult with business unit's and review IT usage, services, technology, and department specific projects. Identify, forecast and develop IT needs. Establish subject matter expertis

Why This Role is Important to Us Commonwealth Community Care's (CCC) Primary Care NP/PA provides comprehensive primary care consultation and management to adults of all ages, familiar with those who have complex physical, developmental, intellectual, and behavioral health conditions, requiring medical evaluation and care. Care is delivered in the office, home, and crisis

Why This Role is Important to Us Commonwealth Community Care's (CCC) Primary Care NP/PA, BOS/SPR provides comprehensive primary care consultation and management to adults of all ages, familiar with those who have complex physical, developmental, intellectual, and behavioral health conditions, requiring medical evaluation and care. Care is delivered in the office, home, an

Why This Role is Important to Us The instED Marketing Specialist Manager will be responsible for building and growing our brand with customers and prospects as well as maximizing the utilization of instED's in home urgent care services by our customers (e.g. health plans and risk bearing provider organizations) and their constituents (patients, members, and providers). To

Why This Role is Important to Us Commonwealth Community Care's (CCC) Primary Care NP/PA provides comprehensive primary care consultation and management to adults of all ages, familiar with those who have complex physical, developmental, intellectual, and behavioral health conditions, requiring medical evaluation and care. Care is delivered in the office, home, and crisis

Why This Role is Important to Us The Palliative Care NP provides consultative specialty services related to serious illness impacts on members and caregivers and care coordination to a defined panel of CCA member's needs. The panel of members will be comprised of individuals with serious illness and may have significant behavioral, psychosocial and medical complexities th

Why This Role is Important to Us The Manager of Internal Audit (Finance) position, based out of Boston MA, is a key member of the Commonwealth Care Alliance's Internal Audit team responsible for the successful completion of the annual audits and testing of internal controls. The position advises the Audit leadership on key risks, provides directions to audit teams on deli