The Staff Accountant is a key member of the Accounting team and works closely with all members of the team in meeting close deadlines, working with various general ledger modules, preparing account reconciliations, and supporting internal and external audits. Positive and team oriented work ethic is critical to this role.

Manages a panel of high risk, medically, behaviorally and socially complex members Administer Comprehensive Assessment, medication reconciliation, convene local care teams, develop, document, and implement integrated care plans Completes timely initial and on going face to face comprehensive assessments with Member to evaluate member's medical, behavioral health, function

The Operations Reporting and Performance Analyst (ORPA) plays an essential role in improving organizational effectiveness by analyzing operational data and identifying opportunities for learning and development. The OPRA collects and analyzes data to assess performance metrics, identifies training needs, and implements strategies to improve employee performance and skill

Assesses member needs by conducting interviews and structured assessments using Motivational Interviewing techniques to engage residents/members and determine non clinical and social needs. Collects data to assist members in better health management. Educates residents/members by providing information on how to obtain resources, basic health information. Provides educatio

Uses SAS and/or SQL coding to pull claims and membership data to support involved healthcare analytics Supports the development of effective medical management programs/initiatives through analyzing, monitoring, and reporting the effectiveness of these programs Develops and implements plans to measure and report on corporate wide health care delivery cost and utilization

The WellSense Health Plan Manager of Hospital and Physician Contracts is responsible for the development, implementation and management of a cost effective provider network, maintaining complex and geographically diverse contracts. The Manager leads a team of Hospital and Physician Contract Managers and is responsible for the development of network wide strategies to impr

Designs, implements, and manages the Business Continuity Program for the health plan Collaborates with department directors and the executive team to develop and implement plans to anticipate, address, and mitigate the effects of various business interruptions Develops, updates and executes business continuity program goals, including development and reporting against met

Reporting to the Director of Contracting, the Operations Manager leads and oversees the reports, audits and other issues concerning all provider contracts, including any pertinent changes and modifications applicable to these contracts. Establishes and monitors Key Performance Indicators. Accountable for quarterly provider directory management, online provider directory i

The Manager of Healthcare Analytics is responsible for financial analysis, measurement, and contract compliance as it relates to WellSense's Clinical Vendors. Working closely with Finance leadership, clinical leadership, and leaders from WellSense's Clinical Vendors, the Manager will ensure the financial integrity of these partnerships by leading the development and commu

The WellSense Plan Manager of Ancillary Contracts is responsible for the development, implementation and management of a cost effective provider network, maintaining complex and geographically diverse contracts. Serves as mentor and manage o Ancillary Contract Managers, leading in the development of network wide ancillary strategies to improve efficiencies and access. Und

The Clinical Care Manager provides holistic medical care management services for members throughout the continuum of care by assessing the member clinically as well as member's readiness to make behavioral changes and actively participate in a care plan, establish goals and meet those goals. Well Sense Health Plan members may include those who have chronic conditions and

Provide short and long term forecasts for various contact centers and departments Including inbound and outbound calls, emails, faxes, chats, written correspondence, claims, enrollment files, caseloads, and other volume based measures Maintenance of current and long term staffing requirements needed to meet service level objectives and other key performance indicators Sup

Position Health Data Analyst III (2 positions available) Location Charlestown (Boston), MA. Report to main office in Charlestown, MA. Eligible to work remotely from anywhere in the U.S. but must work from a state the employer is legally eligible to employ Alabama, Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland

Under the direction of the Vice President of the Senior Vice President of Behavioral Health, the Senior Director of BH Clinical Programs oversees the BH Care Management, BH Utilization Management and Clinical Programming teams. The Senior Director develops and integrates the strategies to enhancing the quality of care for patients, satisfaction, healthcare outcomes in a c

The Licensed Behavioral Health Clinician provides care management services at facilities, in the community and telephonically for WellSense members receiving behavioral health (BH) and substance use services. The Licensed Behavioral Health Clinician works alongside medical Utilization Management and medical Care Management staff, pharmacists, and medical directors as part