Bmc Healthnet Plan jobs

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Prior Authorization Specialist I
BMC Healthnet Plan 5 reviews - Boston, MA
Experience with Health Plan Utilization / Claims departments. Responsible for screening prior-authorization and coordination of specialized services requests in...
Sponsored by CareerArc.com
Claims Quality Assurance Auditor II
BMC HealthNet Plan and Well Sense - Boston, MA
Maintain a comprehensive understanding of Plan benefits, policies, procedures, and claims processing guidelines....
Sponsored by Boston Medical Center HealthNet Plan
EDI Analyst II
BMC HealthNet Plan and Well Sense - Boston, MA
Definition of requirements for applications supporting the HealthNet Plan. Provides mid-level development and support for Electronic Data Interchange (EDI)...
Sponsored by Boston Medical Center HealthNet Plan

Benefits Policy and Implementation Manager Senior Care Optio...

BMC HealthNet Plan and Well Sense - Boston, MA
This individual will also closely monitor state and federal (CMS) legislative changes that have an impact on Plan benefits, policies and will develop...

Medicare Compliance Officer

BMC HealthNet Plan and Well Sense - Boston, MA
Knowledge of CMS and Medicare Advantage Prescription Drug Plans and Special Needs Plans is preferred. And monitors Federal laws, rules, regulations, manuals and...

Data Analyst

BMC HealthNet Plan and Well Sense - Boston, MA
Job Description Job Summary: Under the direction of the Manager of Project Management Operational Analysis, the Data Analyst position is responsible for

Sales Representative Senior Care Option Product

BMC HealthNet Plan and Well Sense - Boston, MA
Job Description Job Summary: Working as part of Market and Community Development sales team, the Sales Representative, Senior Care Options (SCO) Product, is

Senior Project Manager

BMC HealthNet Plan and Well Sense - Boston, MA
Develop detailed project plans and manage cross-discipline resources to meet deadlines. Manage deliverables, understand critical path, develop contingency plan...

Appeals and Grievance Specialist Senior Care Option

BMC HealthNet Plan and Well Sense - Boston, MA
Also ensures compliance with Qualified Health Plans, Commercial/Employer Choice contract regulations, and acts as a liaison between the Plan and the Department...

Manager of Public Partnerships

BMC HealthNet Plan and Well Sense - Manchester, NH
Demonstrated ability to successfully plan and organize contract management activities. Responsible for monitoring local and national regulatory and policy...

Nurse Care Clinician

BMC HealthNet Plan and Well Sense - Manchester, NH
Assesses plans, implements, coordinates, monitors and evaluates care plans, services and outcomes to maximize the health of members....

Vice President of Network Management

BMC HealthNet Plan and Well Sense - Boston, MA
Job Description Job Summary: Reporting to the Chief Financial Officer, The Vice President of Network Management provides leadership for all activities

Project Manager

BMC HealthNet Plan and Well Sense - Boston, MA
Develop detailed project plans and manage cross-discipline resources to meet deadlines. Manage deliverables, understand critical path, develop contingency plan...
Quality Assurance Analyst III
BMC HealthNet Plan and Well Sense - Boston, MA
Utilize test tools such as Quality Center’s requirements, test plan, test lab and defects modules. The Quality Assurance Analyst III participates in and leads...
Sponsored by Boston Medical Center HealthNet Plan
Manager of Care Management Senior Care Options
BMC HealthNet Plan and Well Sense - Boston, MA
Demonstrated ability to successfully plan, organize and manage projects. Accountable for timely notification to the Director if performance falls below...
Sponsored by Boston Medical Center HealthNet Plan

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