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340B Program Oversight Maintains knowledge of policy changes that effect 340B including HRSA, OPA and Medicaid Responsible for conducting all internal 340B audits performed at HHSI (in-house and contract pharmacy) Maintains a current state of “audit readiness.
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The Director of Finance and Strategy, MassHealth Product will be the Finance program lead for the WellSense ACO and MCO programs under the Massachusetts Medicaid product known as MassHealth. General understanding of Medicaid risk adjustment models preferred.
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Overseeing, managing and reviewing government pricing calculations and submissions for programs administered by Centers for Medicare and Medicaid Services (CMS), Public Health Services 340B drug discount program and Federal Supply Schedule programs, and other federal and state programs.
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Maintains knowledge of the policy changes that affect the 340B Program, including, but not limited to, HRSA/OPA rules and Medicaid changes. This position functions as the primary 340B Program contact, HRSA Primary Contact and liaison for all 340B subject matters.
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This position will work across the MassHealth (Massachusetts Medicaid) organization to manage internal and external data sources and reports, and cross functional relationships to ensure delivery of key quality and health equity deliverables.
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Strong knowledge of and/or experience with government programs regulatory, operational, financial, and clinical requirements for the delivery of health insurance and managed care products and services, including Medicare, Medicaid, MMP, LTSS, SNP, Duals, CHIP, and behavioral health, as well as the associated and relevant federal, state, and local regulatory entities.
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Act as physician leader for the Plan for all Medicare Advantage quality management functions: analyze information to develop interventions that improve quality of care and outcomes, with a focus on at risk performance (ex: STARS, State-based programs, VBC.
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Key ResponsibilitiesUnderstanding cross-functional stakeholder needs, facilitating the negotiation of requirements among conflicting priorities across multiple stakeholder groups, and becoming a trusted IT business partner within the remit of Contracts and Pricing, Global Pricing Management, Government and Medicaid Reporting, Gross-to-Net Forecasting, Price Transparency, Health Economics and Outcomes Research.
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Our studies examine the impact of health policies – with a focus on Medicaid and Medicare policy - on access to and use of care, quality, outcomes, spending, and disparities. Reporting to Vicki Fung, PhD, and Alex McDowell, PhD the Clinical Research Coordinator will play a key role in conducting health policy research that examines coverage and access to care for populations that experience health disparities, including individuals of disadvantaged socioeconomic status, racial and ethnic minority populations, and LGBTQ+ populations.
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ROLE SUMMARYThe Clinician, Clinical Scientist (CS) will provide leadership in clinical epidemiological study execution ensuring consistency of approach, conduct, result reporting and oversight of core team activities within one or more specialty or primary asset programs.
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Key Responsibilities:Key contributor within the Government Pricing Team, with demonstrable knowledge and experience in government pricing calculations and reporting requirements including Medicaid, Medicare, 340B and FSS.Works with cross-functional business partners on forecast and accrual estimates, pricing and G2N modeling, and analysis for new and evolving pricing legislation.
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You will report to the Director of Primary Care and will share call coverage with other Concierge physicians. Boston, Mass: We seek a top notch Internal Medicine Physician to join the new elite CONCIERGE MEDICINE PRACTICE launched by one of Americas top hospitals and affiliated with the Harvard Medical School.
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Keywords: RN jobs, Registered Nurse, Clinical Care Management, ACO, Medicaid, Care Team, Community Partners, Care Manager, VinfenIC, VinfenRN, RN, Registered Nurse, Nursing.
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Brigham Health Primary Care is committed to racial justice by building and active enforcement of policies, practices, attitudes, and actions that produce equitable access, treatment, and outcomes for all people.
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Required Qualifications: 1+ years of experience in a network management related role, such as contracting, provider relations or provider services and/or experience working in a dental office 1+ years of experience with Medicaid and Medicare reimbursement methodology (ie.
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medicaid job Title: primary care physician Company: Ima Medical Group in Boston, MA
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