Government Jobs in Boston

Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..

THIS OPEN & CONTINUOUS ANNOUNCEMENT (OCA) ESTABLISHES A STANDING REGISTER OF ELIGIBLE APPLICANTS, which closes on 05/31/2022. The initial cut-off date for referral of eligible applications will be 03/14/2022 with subsequent ..

Description The Referrals Coordinator 2 processes referrals from Civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Typically works on semi-routine assignments. Responsibilities The Referrals ..

Quality & Analytics Manager, Home & Community Based Services (HCBS) Waiver Unit','230000JQ','!*!MassHealth, the Commonwealth of Massachusetts’ Medicaid Program, through its Office of Long-Term Services and Supports (OLTSS), provides a robust system ..

PURPOSE AND SCOPE:Directs, administers and controls the day to day operations and activities of dialysis facilities and programs in an assigned area ensuring compliance with established company and regulatory guidelines and ..

Facility: NEW HOPE PIONEER LODGE Job Description: Promotes health and healing by functioning as a member of the care team to provide optimum care for convalescent, acutely/chronically ill, home care and ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Job Code 2165586 At UnitedHealthcare , were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions ..

Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..

Description If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional ..

Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..

Description Are you passionate about contributing to the well-being of the Medicare population? Are you looking for a role that will let your creative ideas, relationship management and sales ability shine? ..

Job Information Humana Bilingual Quality Auditor in Boston Massachusetts Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..

Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST states Responsibilities The Bilingual Grievances ..

Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..

Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Boston Massachusetts Description Humana is looking for an experienced Healthcare Investigator to join its industry ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

This is an entry-level clinical teaching position within Suffolku2019s nationally ranked Clinical Programs. This position is designed for someone who wishes to launch a career in clinical legal education under the ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..