Why This Role is Important to Us This position includes a variety of clinical support functions for clinical staff, clinical managers and clinical directors who care for CCA's Senior Care Options (SCO) and One Care (ICO) members across the state. These functions are related to the overall workflows of CCA's clinical staff, in addition to managing a variety of internal and

Why This Role is Important to Us This position includes a variety of clinical support functions for clinical staff, clinical managers and clinical directors who care for CCA's Senior Care Options (SCO) and One Care (ICO) members across the state. These functions are related to the overall workflows of CCA's clinical staff, in addition to managing a variety of internal and

Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible

Why This Role is Important to Us The Sr. Associate, Executive IT Support provides concierge level desktop and mobile support to empower and enable CCA executives and their admins to work optimally. This highly visible role must meet enhanced service levels including 24/7 availability (Monday Friday) to resolve issues and provide implementation, maintenance, and end user s

Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible

Why This Role is Important to Us Commonwealth Care Alliance (CCA) is thrilled once again to host its Summer Internship Program for clinical and non clinical departments this year! The Internship Program is open to undergraduate and graduate students from across the country. CCA Internships are a valuable way for students to obtain real world experience, gain exposure to a

Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsi

Why This Role is Important to Us Supervisor & The Team Leader reports to the UM Manager. The Team Leader provides management,oversight and mentorship to team members and ensures that Team members are meeting quality and productivity standards. The Team Leader works in close collaboration with the manager and Director of the UM team. What You'll Be Doing Provide oversight,

Why This Role is Important to Us The Nurse Utilization Management (UM) Reviewer is responsible for day to day timely clinical and service authorization review for medical necessity and decision making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS compliance standards in the area of service decisions and organizational determinations.

Why This Role is Important to Us The Specialist, Quality Provider Engagement ACO/PO monitors Quality Measures within Accountable Care Organization physicians' offices for Group Practice Reporting Options (GPRO). Conducts onsite reviews and audits for Medicare compliance. This position partners with providers to support in office improvement efforts aimed at increasing the

Why This Role is Important to Us The Provider Contract Manager is responsible for developing, negotiating and managing contractual, legal and financial arrangements with providers that ensure CCA members have superior access to the highest quality, cost effective providers of healthcare services. What You'll Be Doing Develop, negotiate and maintain provider contracts for

Why This Role is Important to Us Commonwealth Care Alliance (CCA) is thrilled once again to host its Summer Internship Program for clinical and non clinical departments!The Internship Program is open to undergraduate and graduate students from across the country. Internships are a valuable way for students to obtain real world experience, gain exposure to a specific field

As a Sr. Associate II specializing in Network Analytics, Network Finance, and Value Based Care (VBC) Contracting, this position play a pivotal role in shaping our network strategy, optimizing financial performance, and driving value based care initiatives. This position will collaborate with cross functional teams to analyze network data, assess financial implications, an

Why This Role is Important to Us CCA partners with the Commonwealth of Massachusetts to provide supportive temporary emergency shelter to families under the Executive Office of Housing and Livable Communities' Emergency Assistance program. Our shelter program is part of the Commonwealth's response to a rapidly growing number of unhoused families, including thousands of fa

Support IT communications Review documentation and provide feedback on quality and accuracy Research new ways to conduct business operations Research new technologies and its applicability Provide ideas to resolve risks and issues to IT leadership team Participate in learning and development Maintain active career development plan What We're Looking For Education Bachelor