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 Utilization Management (UM) Reviewer is responsi

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 Nurse Utilization Management (UM) Reviewer is responsible for day to day timely clinical and service authorization review for medical necessity and decision making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS compliance standards in the area of service decisions and organizational determinations.

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 The Manager, Privacy will play a key role in building, operationalizing and sustaining an effective and robust Privacy Program. Reporting to the Director, the role will ensure that the organization complies with relevant and applicable privacy laws, regulations, contractual requirements, and standards. The role will be responsible for deve

Why This Role is Important to Us Commonwealth Care Alliance (CCA) is thrilled once again to host its Summer Internship Program for clinical and non clinical departments!The Internship Program is open to undergraduate and graduate students from across the country. Internships are a valuable way for students to obtain real world experience, gain exposure to a specific field

As a Sr. Associate II specializing in Network Analytics, Network Finance, and Value Based Care (VBC) Contracting, this position play a pivotal role in shaping our network strategy, optimizing financial performance, and driving value based care initiatives. This position will collaborate with cross functional teams to analyze network data, assess financial implications, an

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

Why This Role is Important to Us Commonwealth Care Alliance (CCA) is thrilled once again to host its Summer Internship Program for clinical and non clinical departments!The Internship Program is open to undergraduate and graduate students from across the country. CCA Internships are a valuable way for students to obtain real world experience, gain exposure to a specific f

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

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

Why This Role is Important to Us Commonwealth Care Alliance (CCA) is thrilled once again to host its Summer Internship Program for clinical and non clinical departments!The Internship Program is open to undergraduate and graduate students from across the country. CCA Internships are a valuable way for students to obtain real world experience, gain exposure to a specific f

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 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 Care Alliance (CCA) is thrilled once again to host its Summer Internship Program for clinical and non clinical departments!The Internship Program is open to undergraduate and graduate students from across the country. CCA Internships are a valuable way for students to obtain real world experience, gain exposure to a specific f