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 LTSS Service Authorization Specialist is respons

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 LTSS Service Authorization Specialist is respons

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 The Project Manager is a key project delivery role in the Service Center Business Operations team responsible for delivering projects based on department and corporate priorities. The successful candidate will lead projects by leveraging strong project management skill, leadership, influence, communication, and negotiation based on well es

Support Corrective Action Plan (CAP) Manager in communicating on new and existing CAPs emerging from source programs above and recommended Present updates and reports as requested. Provide support to team members or manager when requested. Other duties as assigned. Secondary Responsibilities Contribute towards the overall Department Regulatory Affairs and Compliance infra

Why This Role is Important to Us Under the direction of the Director, HR Projects, the Organizational Development & Learning Manager will be a key player in actively transforming the employee experience at Commonwealth Care Alliance. This essential role will actively engage in building and delivering best in class learning experiences across the employee lifecycle for emp

Why This Role is Important to Us CCA Primary Care provides primary care for complex patients with disabilities and frail elders in their home, virtually, or at one of our clinic locations. We are an interdisciplinary care team consisting of APCs, physicians, behavioral health clinicians, nurses, medical assistants, rehab, and administrative staff. The Clinical Support Coo

Why This Role is Important to Us Provides support in a clinic setting by managing patient flow through the clinic, obtaining pertinent clinical information including the patient's complaint, health history, and measurement of vital signs, preparing the patient for examination, and implementing patient treatment plans and therapies. Supports the care team in the overall co

Why This Role is Important to Us The Associate Investigator works with a growing team conducting and managing Health Care Fraud, Waste and Abuse investigation and prevention activities under the general direction of the Director or designee. Supervision Exercised No What You'll Be Doing Plan, organize, and execute investigations or audits utilizing document review, witnes

Why This Role is Important to Us The Human Resources Business Partner Director is responsible for providing professional consultative HR guidance and delivery of HR Business Partner services to Commonwealth Care Alliance geographically assigned business unit/s, leaders, and management teams through effective strategic architecting and tactical delivery of the human resour

Why This Role is Important to Us The Lead Software Engineer leads software engineers in the development and support/maintenance of software solutions, including but not limited to integrations, web applications and services, API, ETL processes, batch, and/or job orchestration spanning all systems and functional areas (such as clinical, claims, enrollment, reporting, finan

Why This Role is Important to Us The Lead Software Engineer leads software engineers in the development and support/maintenance of software solutions, including but not limited to integrations, web applications and services, API, ETL processes, batch, and/or job orchestration spanning all systems and functional areas (such as clinical, claims, enrollment, reporting, finan

Why This Role is Important to Us This is a key leadership role that will provide oversight of CCA's multi state Mail Operations. The Mail Operations Manager is responsible for being CCA's subject matter expert for all postage and mailing activities. The Mail Operations Manager ensures compliance with business requirements and with all US Postal Service regulations on post

Why This Role is Important to Us Under direction of the Compliance Manager, , the primary focus of this position is the day to day coordination of oversight activities for CCA's First Tier, Downstream, Related Entities (FDR) and Medicaid Material Subcontractors (MS), also known as the FDR MS Program. This includes review of contract and policy documents, coordinating atte