The Senior Investigator, Corporate Compliance & Ethics is responsible for managing and conducting investigations into concerns or reports of violations of the CCA Code of Conduct, policies and procedures and applicable laws and regulations. The position will be responsible for investigating issues and concerns reported to the Corporate Compliance & Ethics Department, incl

Why This Role is Important to Us The Project Manager is a key project delivery role in the Service Center Business Operations team responsible for delivering projects based on department and corporate priorities. The successful candidate will lead projects by leveraging strong project management skill, leadership, influence, communication, and negotiation based on well es

Support Corrective Action Plan (CAP) Manager in communicating on new and existing CAPs emerging from source programs above and recommended Present updates and reports as requested. Provide support to team members or manager when requested. Other duties as assigned. Secondary Responsibilities Contribute towards the overall Department Regulatory Affairs and Compliance infra

Why This Role is Important to Us Provides support in a clinic setting by managing patient flow through the clinic, obtaining pertinent clinical information including the patient's complaint, health history, and measurement of vital signs, preparing the patient for examination, and implementing patient treatment plans and therapies. Supports the care team in the overall co

Why This Role is Important to Us The Associate Investigator works with a growing team conducting and managing Health Care Fraud, Waste and Abuse investigation and prevention activities under the general direction of the Director or designee. Supervision Exercised No What You'll Be Doing Plan, organize, and execute investigations or audits utilizing document review, witnes

Why This Role is Important to Us The Human Resources Business Partner Director is responsible for providing professional consultative HR guidance and delivery of HR Business Partner services to Commonwealth Care Alliance geographically assigned business unit/s, leaders, and management teams through effective strategic architecting and tactical delivery of the human resour

Why This Role is Important to Us The Associate Device Management Administrator reports to the Sr. Manager, End User Services. The Associate Device Management Administrator deploys and supports Microsoft Modern Management platforms which includes Intune, SCCM, Windows Autopilot, Co management, MEM and Azure Portal. Including all cloud attached and on premises end user devi

Why This Role is Important to Us The Lead Software Engineer leads software engineers in the development and support/maintenance of software solutions, including but not limited to integrations, web applications and services, API, ETL processes, batch, and/or job orchestration spanning all systems and functional areas (such as clinical, claims, enrollment, reporting, finan

Why This Role is Important to Us The Lead Software Engineer leads software engineers in the development and support/maintenance of software solutions, including but not limited to integrations, web applications and services, API, ETL processes, batch, and/or job orchestration spanning all systems and functional areas (such as clinical, claims, enrollment, reporting, finan

Why This Role is Important to Us Reporting to the Health Plan Chief Medical Officer (CMO), the Massachusetts and Rhode Island Market Medical Director is an integral part of a mission driven clinical and market team. The Medical Director's primary responsibilities are to ensure that the clinical processes that contribute to the Massachusetts Duals (SCO/OneCare) and RI DSNP

Why This Role is Important to Us The Provider Relations Specialist is responsible for cultivating, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including primary care practices, sp

Why This Role is Important to Us Under direction of the Compliance Manager, , the primary focus of this position is the day to day coordination of oversight activities for CCA's First Tier, Downstream, Related Entities (FDR) and Medicaid Material Subcontractors (MS), also known as the FDR MS Program. This includes review of contract and policy documents, coordinating atte

Why This Role is Important to Us The Executive Administrator will serve as a critical contributor to the workings of the Chief Revenue and Growth officer and his direct reports including the connection and management of many critical components of the organization. In addition, the Executive Administrator will support the General Manager, Market Lead Massachusetts. What Y

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