Why This Role is Important to Us The CCA Advisor is tasked with working within the Provider Data FACETS team and partnering with our technology partners, claims and other business partners to understand and identify areas in need of process improvements and automation. The Advisor will assess and recommend improvements to operational process flows within the Provider Data

Why This Role is Important to Us Reporting to the Manager, Credentialing & Provider Data, the Provider Directory Manager will perform advanced technical provider directory services work within CCA. It will be the responsibility of the manager to conduct UAT and data analysis on a recurring basis to ensure data accuracy across all lines of business and markets. They will w

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 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 FACETS Provider Data Management Analyst will perform a variety of duties to coordinate and support data management and data entry for the Provider Data Management systems and, depending on the role, FACETS. This will include collaboration with various teams within and outside of the department to effectively collect and process provide

Why This Role is Important to Us The FACETS Provider Data Management Analyst will perform a variety of duties to coordinate and support data management and data entry for the Provider Data Management systems and, depending on the role, FACETS. This will include collaboration with various teams within and outside of the department to effectively collect and process provide

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 Director, Privacy and Security directs and manages Commonwealth Care Alliance's (CCA) efforts to ensure compliance with laws, regulations and policies that govern information privacy and security including, but not limited to Health Insurance Portability and Accountability Act (HIPAA), Health Information Technology for Economic and Cli

Why This Role is Important to Us Reporting to the Director, Privacy & Security Compliance, the Manager, Privacy & Security Compliance, oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to Commonwealth Care Alliance (CCA) security policies and procedures covering oversight of security in compliance with federal and st