Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral health, functional status, and socioeconomic needs Administers MDS HC assessments and other required assessment tools Facilitates meetings of the PCT and serves as clinical subject matter

Manages a panel of high risk, medically complex members Completes timely initial and on going face to face comprehensive assessments with Member to evaluate Member's medical, behavioral health, functional status, and socioeconomic needs Administers MDS HC assessments and other required assessment tools Facilitates meetings of the PCT and serves as clinical subject matter

The Manager of Risk Adjustment and Trend Analytics is a key member of the Finance management team. Under supervision of the V.P of Financial Planning and Performance Analysis, the Manager oversees risk adjustment analysis primarily related to the MassHealth Medicaid and New Hampshire Medicaid lines of business, directly impacting and improving the revenue for these produc

The Manager of Consumer Sales is a sales leader focused on sales growth for our Massachusetts Senior Care Options (SCO) product. Working closely with the VP of Sales, the Manager will develop a business plan to ensure the sales team consistently achieve or exceed sales goals as well as collaborating with community partners and Boston Medical Center Health System (BMCHS) t

The Staff Accountant is a key member of the Accounting team and works closely with all members of the team in meeting close deadlines, working with various general ledger modules, preparing account reconciliations, and supporting internal and external audits. Positive and team oriented work ethic is critical to this role. Our Investment in You Full time remote work Compet

The Operations Trainer develops a wide variety of training programs and materials to support the Claims, Call Center, and Enrollment teams. The trainer researches, develops, and facilitates in house training courses for new and existing employees. Develops training competency tools that will ensure the quality, consistency and timeliness of department activities. Maintain

The Culture and Engagement Program Manager is responsible for developing strategies to improve engagement, and manage programs and processes designed to foster it, such as the employee engagement survey, employee recognition, training and development, wellness and other activities aimed at creating a positive workplace environment. Implement and drive an integrated cultur

Generates and/or distributes member documents and files Data entry of confidential member information into multiple databases Generates simple reports for care management team Initiates and follows up on requests for provider information Assists in scheduling Primary Care Team meetings and exchanging information, facilitating communication among team members as needed Ass

Monitors actual FCR and NPS performance against corporate targets; presents findings; proactively investigates and communicates explanations for variation and conducts root cause analysis. Provides critical data analysis and recommendations to establish corporate goals related to FCR and NPS. Conducts deep analysis on data related to FCR and NPS, reviews member surveys, l

Reporting to the Manager of Consumer Sales and Performance, the Broker Account Executive is a licensed sales professional with experience in Medicare/Medicare Advantage and individual ACA markets and is responsible for building and managing relationships with WellSense's contracted brokers. The Broker Account Executive provides strategy support and product training broker

Utilize appropriate resource materials to own interactions in order to effectively and accurately interpret respond and resolve customer inquiries and problems while delivering outstanding service as a means to build loyalty, improve retention, and satisfy best in service goals and objectives Respond to a high volume of incoming calls from members and providers (call leng