Medicaid Claims Quality Lead
Mass General Brigham Health Plan
Mass General Brigham Health Plan is an employer within Mass General Brigham, dedicated to transforming health care with innovative solutions and a strong commitment to patient care and community service. The Supervisor, Medicaid Claims Review leads a high-performing team focused on Medicaid claims quality, payment accuracy, and adjudication integrity. This role oversees daily inventory management and works with cross-functional partners to drive continuous improvement. #J-18808-Ljbffr Mass General Brigham Health Plan
- Mass General Brigham Health Plan is seeking a Supervisor, Medicaid Claims Review to lead a high-performing team focused on Medicaid claims quality, payment accuracy, and adjudication integrity. This role oversees daily inventory and works with cross-functional teams to...QualityClaimsRemote job
- ...transformation with one of the world's leading integrated healthcare systems. Together... ...opportunities, and much more. The Supervisor, Medicaid Claims Review is responsible for leading a... ...team focused on Medicaid claims quality, payment accuracy, and adjudication integrity...QualityClaimsWork at officeFlexible hours
- Mass General Brigham Health Plan Holding Company, Inc. seeks a Supervisor, Medicaid Claims Review to lead a high‑performing team focused on claims quality, payment accuracy, and adjudication integrity. This role oversees daily inventory and collaborates with cross‑functional...QualityClaimsRemote jobMonday to Friday
$122.25k - $176.58k
...internet websites and social media (global). Define the minimal quality standard and processes to be applied worldwide. Support the set... ...transformation initiatives like Gen AI, Modular Content, Core Claims, and or other MLR programs.Familiarity with regulatory technology...QualityClaimsFull timeWork at officeLocal areaWorldwide$79.56k - $115.72k
...General Brigham Health Plan Supervisor, Medicaid Claims Review Mass General Brigham Health... ...transformation with one of the world's leading integrated healthcare systems. Together... ...performing team focused on Medicaid claims quality, payment accuracy, and adjudication...QualityClaimsFull timeWork at officeRemote workMonday to FridayFlexible hoursShift work$178.5k - $257.83k
...patient care and access. As HEOR experts, we lead the generation and dissemination of... ..., translation, and dissemination of high-quality, decision-relevant evidence to support access... ...with US real-world data sources (e.g., claims databases, electronic health records) and...QualityClaimsFull timeWork at office3 days per week$125k - $150k
Financial Recovery Technologies (FRT) is a leading technology-based services firm that helps... ...community identify eligibility, file claims, and recover funds from securities class... ...acquisition and nurture programs that drive high-quality pipeline.Own campaign performance end-to-...QualityClaimsTemporary workWork at office2 days per week3 days per week- ...to transform patient outcomes. We built a leading performance-driven network of 100+ sites... ...and performance management to ensure high-quality execution and professional development... ...and I promise I will not bring any legal claims or actions against my current or former employers...QualityClaimsContract workTemporary workFor contractorsFor subcontractorH1bWork at officeLocal areaWork visa2 days per week
$177k - $278.08k
...Job DescriptionAbout the role:Global Brand Lead, IgAN (Director level), reporting to the... ...and test the target product claims and key messagesBuild the brand book to provide... ...to support efficient, compliant, and high-quality execution.Contribute to launch roadmap planning...QualityClaimsMinimum wageTemporary workLocal area- ...global professional services company with leading capabilities in digital, cloud and... ...functional specifications. Participate in quality management reviews of the design and performance... ...support. Epic Tapestry certification in Claims, E&E, Benefits Engine, CRM, or UM -...QualityClaimsFull timeWork experience placementLive inWork at officeLocal area
$25 - $29 per hour
...and work from home! The Bankruptcy Team Lead will be responsible for monitoring residential... ...control reports to ensure overall quality and performance of the Bankruptcy processes... ...filings process, Motion for Reliefs, Proof of Claims, Transfer of Claims, Reaffirmations,...QualityClaimsExtra incomeWork experience placementWork from home$21 - $28.26 per hour
...making a difference in people's lives. Lead Health Information Management Audit... ...provide efficient and thorough healthcare claims auditing requirements for Beth Israel Lahey... ...for reimbursement, regulatory compliance, quality, and appropriateness. Assists in the medical...QualityClaimsHourly payWork experience placementWork at officeShift work$21 - $28.26 per hour
...Manager, Health Information Management, a Lead Health Information Management Audit... ...provide efficient and thorough healthcare claims auditing for Beth Israel Lahey Health (BILH... ...for reimbursement, regulatory compliance, quality, and appropriateness. The role includes medical...QualityClaimsHourly payWork experience placementWork at officeShift work- Gallagher Bassett is seeking a senior supervisor to lead a Workers' Compensation claims team in a fully remote capacity. The role focuses on delivering high-quality service, mentoring adjusters, and aligning practices with company standards. Requirements include a long...QualityClaimsRemote job
- ...Management Supervisor in Burlington, MA. This role provides leadership to the Nurse Case Management team within the Claim Department and ensures high-quality care coordination and return-to-work planning. The position requires a BSN or bachelor’s degree, Certified Case...QualityClaims
- ...with departmental policy and within each Medicaid, ACA, CMS or NCQA mandated turnaround times... ...rate negotiation accurately for proper claims adjudication Identify and refer potential... ...problem-solving abilities with focus on quality improvement initiatives Working Conditions...QualityClaimsWork at officeRemote work
$130k - $150k
...health care and digital health. You will lead client engagements, manage and galvanize... ...tracking, staffing and billability.Ensure the quality of the account team(s) is held to the... ...make payments to any unverified sources claiming to be connected to Real Chemistry. We are...QualityClaimsWork experience placementWork at officeLocal areaRemote workFlexible hours2 days per week$206.25k - $297.92k
...pricing programs more broadly (Medicaid Drug Rebate Program, Federal... ...~ Serve as day-to-day legal lead on a defined portion of Sanofi... ...Experience litigating constitutional claims, statutory and regulatory... ...wellbeing benefits including high-quality healthcare, prevention and...QualityClaimsContract workShift work- ...plan standards, credentialing activities, claims processing, directory accuracy, and... ...Services, and Compliance teams to maintain high-quality provider data and support exceptional... ...data complies with Centers for Medicare & Medicaid Services (CMS), Department of War (DoW),...QualityClaimsWork at officeLocal area
- ...information related to benefits, eligibility, claims, referrals, and care coordination for... ...performance indicators (KPIs), including quality, productivity, and member satisfaction.... ...insurance, especially TRICARE or Medicare/Medicaid is preferred. ~ Knowledge of USFHP or military...QualityClaimsWork at officeLocal area
$120.1k - $138.2k
...Farber Cancer Institute’s (DFCI) Quality and Patient Safety (QPS)... ...Commission, Centers for Medicare and Medicaid Services (CMS), and Food and... .... Analyzes incident reports, claims, and other data to identify... ...defined by policy and protocol. Leads investigations into adverse events...QualityClaimsWork at office- ...and validate ML and predictive analytics solutions that drive data-informed decisions across the US market. You will lead analytics, integrate claims and EHR data, and partner with Insights, Medical Affairs and IT to inform strategies, optimize opportunities, and accelerate...Claims3 days per week
- MWRA in Chelsea, MA seeks a Coordinator to implement construction claims management programs for engineering and construction projects. The role involves coordinating contract claim processes, reviewing contractor claims, and supporting engineers and management in claim...ClaimsContract workFor contractorsRemote workMonday to Friday
- ...We are seeking an experienced Computer System Validation (CSV) Lead to oversee validation activities for computerized systems used in... ...decommissioning projects. Coordinate validation activities with IT, Quality Assurance, Engineering, Manufacturing, and Business teams....Quality
- ...Maintenance Supervisor. Our client is a leading food manufacturer, specializing in delivering foods and snacks with unparalleled quality and flavor. This plant-based role is responsible... ...be able to meet volume goals, reduce claims, maximize yields, and reduce cost ·...QualityClaims
$206k - $257.5k
...President, Global Medical Affairs Strategy and Field, the MSL Team Lead is responsible for the development of the vision, strategy and... ...proactive status reports that visualize KPIs and demonstrate quality of team outcomesLeads by example, driving a culture of teamwork...QualityFull time$178.5k - $257.83k
...impossible into possible for millions. As Global Periodic Reporting Lead within our Pharmacovigilance team, you will ensure and develop... ...a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks...QualityFull timeWorldwide$95k - $245k
...direction of Scholar, co-op, and internship cohorts•Ensuring the quality of technical work products produced by the group, contributing... ...members.Convey relevant information from management to group members.Lead, mentor, build depth in their area of expertise, and conduct...QualityFull timeWork at officeLocal area$178.5k - $257.83k
...Morristown, NJAbout the jobAs the Biomarker and Precision Medicine Lead, you’ll be developing and implementing translational medicine... ...with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14...QualityFull timeWork at office$178.5k - $257.83k
...impossible into possible for millions. As Health Value Translation (HVT) Lead within our Patient Driven Medicines Development (PDMD) function,... ...a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14...QualityFull timeWork experience placementLocal area
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