Job Summary: The Integrated Care Clinical Manager - Massachusetts at CareSource/Commonwealth Care Alliance (CCA) 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
Job Summary: The Integrated Care Clinical Manager - Massachusetts at CareSource/Commonwealth Care Alliance (CCA) 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
Job Summary: The Market Development Partner (MDP) is responsible for cultivating and managing strategic relationships with key market stakeholders, including healthcare providers, community-based organizations, LTSS entities, and advocacy groups, driving growth by self-generating leads and supporting
Job Summary: The Actuarial Analyst I is responsible for providing timely, accurate, and actionable data and analysis supporting the department, area, and corporate key initiatives. Essential Functions: Develops actionable recommendations to management relative to all analysis
Job Summary: The Director, Model Engineering & Operations is responsible for leading the strategy, development, implementation, and optimization of enterprise AI and machine learning solutions that support core health plan operations and business objectives. This role
Job Summary: The AVP, Hospital and Integrated Delivery System (IDS) Network Contracting provides leadership for the Massachusetts markets provider contracting strategy across hospitals, health systems, and related physician organization networks. The AVP is responsible for developing
Job Summary: The AVP, Actuarial Science, is responsible for driving and supporting company strategy and managing actuarial expertise in coordination with others to ensure actuarial soundness, and to use actuarial knowledge and tools to help improve
Job Summary: The Director, Actuarial Science is responsible for guiding the strategic direction, driving innovation and producing key insights for the organization that drive company performance. Essential Functions: Accountable for pricing, forecasting, month-end close activities and
Job Summary: The Senior Director, Actuarial Science is responsible for setting the strategic direction, driving innovation and producing key insights for the organization that drive company performance. Essential Functions: Accountable for pricing, forecasting, month-end close activities
Job Summary: The National Network Program Manager will support day-to-day operations across National Network programs by managing deliverables, maintaining documentation, and coordinating the flow of information across teams. The Program Manager acts as the connective layer
Job Summary: The Enterprise Enablement, Analytics and Toolchain Integration Lead owns enterprise adoption, visibility, analytics, and AI-enabled tool use that support consistent, high-quality requirements delivery across federated teams. This role is not an AI-specific role; it
Job Summary: The Business Analyst IV is a senior-level position responsible for driving strategic initiatives and leading cross-functional teams to deliver innovative solutions that address complex business challenges. This role bridges the gap between business needs
Job Summary: The Growth Director is responsible for managing capture and proposal strategy efforts throughout the entire life cycle of a procurement to win new and existing Medicaid business. Essential Functions: Partner with the Growth team,
Job Summary: The Integrated Care Clinical Manager - BH - Massachusetts is a community based BH Clinician responsible for providing monitoring, follow-up and clinical care management to dually eligible enrollees with complex medical, behavioral and social
Job Summary: The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members. Essential Functions: Provide prior authorization medical reviews, consultation and clinical review services Participate in peer-to-peer
Job Summary: The Utilization Management (UM) Market Operations Manager is responsible for the operational activities of UM and Appeals for a specified line(s) of business managing the development of policies and procedures, review of team metrics,
Job Summary: The Supervisor, Care Management provides front line management and support to Clinical Care Managers in the execution of care coordination tasks for members requiring RN and BH care managers. Essential Functions: Functions as a
Job Summary: The Enterprise Quality Statistician leads, implements, and conducts analysis for quality and performance improvement and population health processes through the integration of quality improvement science and advanced statistical methodologies. Essential Functions: Serve as the
Job Summary: The Administrative Assistant III is responsible for meeting the administrative needs of their executive and assigned organization within the company. This is a hybrid position that works in the Dayton OH office as needed.
Job Summary: The Market Development Partner (MDP) is responsible for cultivating and managing strategic relationships with key market stakeholders, including healthcare providers, community-based organizations, LTSS entities, and advocacy groups, driving growth by self-generating leads and supporting