Bmc Healthnet Plan jobs in Massachusetts

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Director of Provider Audit and Special Investigations
BMC HealthNet Plan - 17 reviews - Boston, MA 02116
Designs, implements and monitors strategies to ensure that the Plan pays only for medically necessary services provided to eligible members by eligible provider...
Manager of Analytics
BMC HealthNet Plan - 17 reviews - Boston, MA 02116
Participate in comprehensive plans for transitioning processes to vendors and for managing vendor relationships to ensure maximum, sustainable benefits....
Senior Internal Auditor
BMC HealthNet Plan - 17 reviews - Boston, MA 02116
Ability to successfully plan, organize and manage audit projects. Independently plan and conduct operational internal and compliance audits....

Quality Improvement Coordinator, Boston HealthNet (40 hrs, D...

Boston Medical Center (BMC) - Boston, MA 02118 (South Boston area)
Plan, organize, and prioritize work in order to meet organizational goals, objectives and deadlines. BMC will make reasonable accommodations for qualified...

Customer Care Representative

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
$18 an hour
Well Sense Health Plan is the largest Medicaid health plan in New Hampshire with more than 70,000 members. Boston Medical Center HealthNet Plan (BMCHP) is a not...

Senior Provider Relations Consultant

BMC HealthNet Plan - 17 reviews - Massachusetts
Outreaches to providers according to Plan initiatives. Takes the lead on specific Plan initiatives as they relate to provider education....

LTSS Coordinator SCO

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
 Prior health plan experience.  Experience with health plan utilization/claims in a provider or payer environment....

Claims Adjudicator

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
Responsible for the accurate and timely processing of claims. Must meet published quality and productivity standards. Also, responsible for adjustments to...

IUM Specialist

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
Experience with Health Plan Utilization. Experience with Health Plan Utilization / Claims departments. Inpatient Utilization Management Specialist....

UM Program Coordinator

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
Identify and review all regulatory reporting specifications that apply to appeals and grievances and specific regulatory UM reporting (including working with...

Prior Authorization Specialist I

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
Experience with Health Plan Utilization / Claims departments. Responsible for screening prior-authorization and coordination of specialized services requests in...

Correspondence Coordinator, Utilization Management

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
The Correspondence Coordinator is responsible for completing member and provider notification letters for the Utilization Management (UM) department within...

Program Coordinator Special Kids Special Care

BMC HealthNet Plan - 17 reviews - Boston, MA 02116 (South End area)
Prior health plan experience. Experience with health plan utilization/claims. Ensure timely distribution of the SKSC Quarterly ICPs (Individualized Care Plans)....
Care Management Senior Program Manager
BMC HealthNet Plan - 17 reviews - Boston, MA 02116
Assists CM Managers with maintenance of CM quality improvement work plans and other quality and performance tracking documents....
Clinical Trainer
BMC HealthNet Plan - 17 reviews - Boston, MA 02116
Well Sense Health Plan is the largest Medicaid health plan in New Hampshire with more than 85,000 members. Boston Medical Center HealthNet Plan is a not-for...