Nurse Care Manager SCO
Boston, MA
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...

Care Management Coordinator, SCO
Boston, MA
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...

Pharmacy Operations Specialist
Boston, MA
Receive, process, and review all prior authorization requests received through fax, phone, or electronic prior authorization systems in accordance with all regulatory and accreditation r...

Manager of Risk Adjustment and Trend Analytics
Boston, MA
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 Manage...

Customer Service Trainer
Boston, MA
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 facilita...

Broker Account Executive
Boston, MA
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 AC...

Senior Health Data Analyst
Boston, MA
WellSense Health Plan is seeking a dedicated and experienced Senior Health Data Analyst to join our team on a full time, regular basis. The Senior Health Data Analyst is a key member of...

Executive Assistant to the President
Boston, MA
The Executive Assistant role provides comprehensive administrative support to the WellSense President and executive team in managing daily business operations, communications and coordin...

Pharmacy Program Manager
Boston, MA
Responsible for accurate and timely implementations of pharmacy benefits and operations configurations Provides project management support for all pharmacy services initiatives across al...

PA Specialists Supervisor
Boston, MA
Responsible for the daily supervision and operations of the Prior Authorization Specialists. Develops training, trains staff, assigns work, implements policies and procedures, and resolv...

Investment Staff Accountant
Boston, MA
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, prepar...

Operations Reporting and Performance Analyst (Learning and Development)
Boston, MA
The Operations Reporting and Performance Analyst (ORPA) plays an essential role in improving organizational effectiveness by analyzing operational data and identifying opportunities for...

Care Manager - Pediatric
Manchester, NH
Manages a panel of high risk, medically, behaviorally and socially complex members Administer Comprehensive Assessment, medication reconciliation, convene local care teams, develop, docu...

Manager of Hospital and Physician Contracts
Boston, MA
The WellSense Health Plan Manager of Hospital and Physician Contracts is responsible for the development, implementation and management of a cost effective provider network, maintaining...

Manager of Ancillary Contracts
Boston, MA
The WellSense Plan Manager of Ancillary Contracts is responsible for the development, implementation and management of a cost effective provider network, maintaining complex and geograph...