1,796 managed care jobs at 452 companies in Boston, MA
5d
Save
Mark Applied
Hide
5d
Managed Care Operations Manager
Worcester, Massachusetts, United States
$72k-$129k/yrHybridFull Time
UMass Memorial Health: Provides integrated medical care and clinical research in Massachusetts.
5+ YOEBachelor’s degree or equivalent in business administration, healthcare management, or related field; 5–7 years in managed care; expertise in plan operations, billing, clinical operations, healthcare terminology, and managed care policy.
Family Health Center of Worcester: Provides integrated medical, dental, and behavioral health services.
2+ YOETwo to four years college or relevant work experience; minimum two years in patient services or similar medical field; proficient with electronic medical systems and data entry; strong customer service.
Managed Care Coordinator - (Referrals) Gastroenterology
Plymouth, Massachusetts, United States
$23-$30/hrOnsiteFull Time
Beth Israel Lahey Health: Integrated regional healthcare provider operating hospitals and clinical centers.
1+ YOECoordinate and process managed care referral authorization requests; proficient with web-based payer systems and Microsoft Office; 1-3 years related experience; HS diploma/GED required.
Point of Service Device (POS), Health Wire Network, Aetna WebMD, NEHEN, HPHC Connect, Navinet, NIA, Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Access
Mass General Brigham: Provides integrated medical care, research, and clinical training services.
2+ YOE2+ years managed care billing and collections experience; knowledge of insurance practices, strong communication and organizational skills, ability to analyze data and use billing systems.
Vertex PharmaceuticalsNASDAQ: VRTX: Develops and sells prescription drugs for serious genetic diseases.
8+ YOELead end-to-end managed care contract development, perform pre/post-deal analytics, support negotiations, and liaise with cross-functional partners; requires bachelor's in business and 8+ years payer contracting/analytics experience.
Microsoft Excel, Microsoft Word, Microsoft PowerPoint
Boston Children's Hospital: Providing comprehensive pediatric healthcare and medical research services.
Bachelor’s degree in business, finance, or related field required. Requires analytical, organizational, communication, documentation, and Excel skills, including formulas, VLOOKUP, and pivot tables.
Care New England Health System: Integrated non-profit health system providing hospital and medical services.
4+ YOECurrent RI RN license, care management certification (CCM or ACM) within one year, BLS, 4 years acute care experience, care management and leadership experience, BS in Nursing (or enrolled), EMR/system knowledge.
Griswold Home Care: Provides non-medical in-home care for seniors and adults
High school diploma/GED required. Strong verbal/written communication, scheduling and computer skills, ability to multitask and manage priorities; home care or healthcare scheduling experience preferred.
Traditional Care Director, Assisted Living Neighborhood
North Andover, Massachusetts, United States
$70k-$72k/yrOnsiteFull Time
Benchmark Senior Living: Operates senior living communities providing personalized care and housing.
Responsible for managing assisted living program, staff hiring/supervision, quality assurance, regulatory compliance, budget and resident/family satisfaction; undergraduate degree preferred; knowledge of dementia care and Microsoft Office required.
Microsoft Office, YARDI, UltiPro, UTA, ERSP, VLT, ULM
Care New England Health System: Integrated non-profit health system providing multi-specialty medical care.
4+ YOECurrent RI RN license, care management certification (CCM or ACM), BLS, 4 years acute care experience, care management and leadership experience, competency with Cerner/InterQual/3M/Microsoft Office.
Careforth: Providing expert coaching and support for family caregivers.
2+ YOEActive state RN license, 2+ years recent direct care experience with elders or adults with disabilities, case management experience, valid driver\u0019s license and auto insurance, and proficiency with MS Office and case management systems.
Seattle or Spokane or Bellingham or Everett or Vancouver
$30-$59/hrFieldFull Time
Molina HealthcareNYSE: MOH: Provides managed health insurance through government-sponsored benefit programs.
2+ YOEActive unrestricted RN license, 2+ years healthcare experience (care management preferred), valid driver's license and reliable transportation, EMR proficiency, strong communication and critical-thinking skills.
Electronic Medical Records (EMR), Microsoft Office
Care New England Health System: Integrated non-profit health system providing hospital and medical services.
4+ YOERN license in Rhode Island, BLS, CCM or ACM certification, 4+ years acute care experience, care management and supervisory experience, knowledge of Cerner/InterQual/3M/Microsoft Office, strong leadership and regulatory knowledge.
Sunrise Senior Living: Provides assisted living, memory care, and senior housing services.
High school diploma or GED; CPR and First Aid as required; 18+; previous senior care experience preferred; ability to make decisions in residents' best interest.
Sunrise Senior Living: Provides assisted living, memory care, and nursing services.
High school diploma/GED and age 18+ required. CPR/First Aid required or obtainable. Must provide compassionate personal care, communicate effectively, and support resident safety and independence.
WellSense Health Plan: A nonprofit health insurance provider offering Medicare, Medicaid, and individual plans.
3+ YOECurrent Massachusetts RN license, 3+ years pediatric clinical/home health/managed care experience, care coordination skills, motivational interviewing, EMR and Microsoft Office proficiency, reliable transportation for in-person visits.
FACETS, Jiva, Microsoft Outlook, Microsoft Word, Microsoft Excel
Sunrise Senior Living: Operator of senior living and memory care communities.
Provide hands-on resident care including ADLs, follow ISPs and document changes, promote safety and dignity, CPR/First Aid or ability to obtain, high school diploma/GED, age 18+.
Charter Senior Living: Operates and manages senior living communities across the United States.
3+ YOE1+ Mgmt3+ years senior living experience with at least 1 year in dementia/memory care leadership; associate degree required (bachelor's preferred); experience managing behavioral care and care planning; preferred CDP, ADC, or CTRS.
Behavioral Health Network: Provides mental health and substance use disorder treatment services.
1+ YOEHigh school diploma or GED, RN license, 1–2 years of related behavioral health, human services, or medical experience, driver's license, reliable registered vehicle, and care management knowledge.
Brown University Health: Academic healthcare system providing comprehensive hospital and clinical services.
0.5+ YOEProvide therapeutic residential care for children, document observations, implement care plans; requires Baccalaureate in Human Service or equivalent experience, 6+ months child care experience, Crisis Management, CPR, ERS, Safety & OSHA certifications.