9 human resources director jobs found in Boston

The Executive Office of Health & Human Services (EOHHS) is actively searching for a Deputy Director of Federal Finance and Revenue. The ideal candidate has extensive experience working with various federal programs, regulations, and state accounting principles. The Deputy Director will be responsible for providing strong leadership and management with the management of daily operations of the Office of Federal Finance and Revenue (OFFR); manage revenue leads who work with assigned EOHHS agencies in developing, analyzing and monitoring revenue forecasts and maximization projects; identify, review and analyze potential future revenue projects; develop and maintain a system for project management and reporting. The Deputy Director of Federal Finance and Revenue will report to the Director of the Office of Federal Finance & Revenue and will oversee a team of four Revenue Leads. Duties and Responsibilities (these duties and responsibilities are not all inclusive):...

John Hancock is currently transforming our Long Term Care business to help our customers age in place and receive the care that they need to live as independently as possible. This team focuses on providing access to high-quality and affordable long-term care providers to our customers when they need it. The Director, Provider Network Development & Relationship Management, is responsible for leading the development, optimization, and strategic oversight of our provider network. This role is responsible for ensuring network adequacy, driving value, and fostering strong relationships with healthcare providers, network partners, and internal stakeholders. The ideal candidate brings a blend of business development, contract negotiation skills, strategic thinking, and a passion for improving healthcare access and quality across diverse populations for our long-term care policyholders. Position Responsibilities Network Strategy & Design: Lead cross-functional team to...

Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Earn a $5,000 hiring bonus! Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment." Location: Remote - United States Schedule: 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST Required to work every 5th Saturday Required to work 1 company holiday...

Become a part of our caring community and help us put health first The Risk Management Professional 2 identifies and analyzes potential sources of loss to minimize risk. The Risk Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines and procedures. As a Risk Management Professional 2 - HCPR Compliance, you will work with HCPR Operations to ensure operational processes are complaint with appropriate regulations and report data that accurately reflects operations. In this role you will: In this role you will: Develop data universe generation guidelines (DUGG) for audit universes by interpreting protocols/guidance and reconciling it to processes/system logic Produce monthly...

Become a part of our caring community and help us put health first The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment. The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives. This role requires an in-depth understanding of Home Health...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Humana. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission...

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Senior Compliance Analyst (Regulatory Change Management) - Remote Job Description The Senior Compliance Analyst assists in the implementation of Prime's compliance programs and leads initiatives within their designated areas. This role partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Lead project management efforts for highly sensitive...

Become a part of our caring community and help us put health first The Workforce Management Professional 1 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, diversity and human resource compliance). The Workforce Management Professional 1 work assignments are often straightforward and of moderate complexity. The Workforce Management Professional 1 assesses organizational staffing and identifies requirements and solutions to meet workforce objectives. Provides analysis of talent and staffing needs based on strategic planning at the enterprise level. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented...