Massachusetts
Provider Systems Analyst
Administrative Assistant/Provider Relations Coordinator
Programmer Analyst
Marketing Outreach Representative
RN Care Manager
Provider Systems Analyst
The Provider Systems Analyst is accountable for ensuring Intellicontract, a contracting process flow and document management system, meets the business needs of the company. The candidate is responsible for the implementation, maintenance and future upgrades of the system, serves as the subject matter expert for Intellicontract and acts as a liaison between the software vendor, SWH internal IT department and functional lead for contracts.
Bachelor’s Degree desired, HS Diploma or equivalent required. 3-5 years experience working in a Managed Care Organization. Experience with system configuration and set up. Highly self-motivated with the ability to complete projects independently within established time frames.
Administrative Assistant/Provider Relations Coordinator
The candidate will provide administrative support to the Provider Relations team.
The following are some of the main responsibilities of the role:
- Answer Provider calls that include questions about (but not limited to) eligibility, benefits, authorizations, participation in network, status of changes, claims, etc.
- Perform routine maintenance in the provider database as appropriate
- Prepare gap analyses for various markets
- Provide Physician offices with PCP assessment forms, referral requests and other documents
- Scanning, faxing, filing, tracking, data entry of Provider and other misc. documents
- Manage incoming fax referrals including documenting, managing and recording contract and related document intake
- Schedule meetings, coordinate catering, take meeting minutes and other general administrative duties as assigned
A minimum of 5 years experience in an administrative support role. Proficiency in MS Office products, especially Word, Excel and Access. Proven time management, organization and communication skills. Strong customer service skills and the ability to meet deadlines by multi-tasking. Minimum 3 years experience in Provider Relations strongly recommended. Prior experience in the healthcare field preferred.
Programmer Analyst
The candidate will design, code, test and analyze software programs and applications. This includes researching, designing, documenting and modifying software specifications throughout the production lifecycle and analyzing and amending software errors in a timely and accurate fashion and provide status reports as required.
Working technical knowledge of programming languages including ASP, VB.NET, Microsoft SQL, PL/SQL. Familiarity with Healthcare software development methodologies. Degree in computer science or software engineering and/or 8 + years equivalent work experience. Hands on experience working with software troubleshooting, enterprise healthcare applications, integrated development environments, and SQL database server 2000, 2005, 2008. The candidate will be flexible, highly logical, technically proficient and must have the ability to prioritize in a high-pressure environment. Overtime may be required to meet deadlines and some travel may be required for off-site software installation.
Marketing Outreach Representative
The Outreach Representative will be responsible for following up on sales leads and information requests for potential participants; assisting potential members in the application process and arranging for and conducting community outreach activities. We are seeking a candidate for a temporary 3 month assignment with a possibility of full-time.
Responsibilities include, but are not limited to:
- Providing information and answers to all questions from potential members regarding benefits, rights and responsibilities and plan operations;
- Identifying and organizing community outreach activities to spread awareness of coverage options
- Meeting and reviewing monthly sales-related goals and objectives
- Employing lead generation and follow up according to company standards
- Self-reporting on any potential violations of federal, state or company regulations and guidelines
This is an outside sales position requiring up to 90% local travel in the community and provider areas. Sales, customer service and/or community outreach background required. Must have a driver’s license and reliable transportation. Territory covers all of Massachusetts. Candidates with a valid Accident and Health License preferred. Knowledge of Medicare and/or Medicaid community-based programs is a plus.
RN Care Manager
Nurses work collaboratively within a supportive organization of professional colleagues to build relationships with providers and members. In collaboration with the elder’s primary care physician and an interdisciplinary team, the Nurse Care Manager develops, implements and monitors an individual care plan for our members. Our goal of the care plan is to improve the health status, functioning and quality of life for SWH members in their preferred place of residence. We serve poor elders who speak a variety of languages. Our nurses help organize medical resources in collaboration with community providers.
Requirements - Massachusetts Registered Nurse License; strong clinical and assessment skills; outstanding communication skills; self-motivation, organization and flexibility; commitment to improve care in underserved populations; collaborative work style; relationship building; work entails meeting directly with members, their families and providers in home and office settings; high level of accountability; personal car for job related travel; computer skills. Home care, long term care, care management experience a plus.
We are seeking Nurse Care Managers for a variety of positions in Greater Boston/Cambridge and Brockton; our offices are located in Cambridge and Raynham. Candidates with bilingual skills are strongly encouraged to apply.
Utilization Management Nurses are also needed on a full-time or part-time basis to work in our Cambridge or Raynham offices.
Last modified: 08/17/2010