Enrollment Coordinator RN Location US MA Dartmouth Job ID 7557 # Positions 1 Category Care Coordination Overview About us Fallon Health is a company that cares. We prioritize our members always making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high quality coordinated care and are continually rated amon

Principal responsibility of the Operations Support Service Analyst IV (Senior Business Analyst) is to collaborate with business areas to design, develop, modify and test reports to support business needs and transaction management. The analyst will leverage their developer skill set and experience with large health care data sets and relational databases to develop comple

Social Worker II Location US MA Webster Job ID 7560 # Positions 1 Category Social Work Overview About us Fallon Health is a company that cares. We prioritize our members always making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high quality coordinated care and are continually rated among the nation's to

Responsible for the analysis, negotiation/renegotiation, implementation, readjustment, evaluation, and continuous improvement of all functions of provider contracting. Manages financial and operational issues related to contractual provider arrangements. Responds to both internal and external customers regarding provider contractual arrangements, both for contract impleme

Applying accounting and business knowledge, supports the Treasury Accounting team by Reviewing daily banking activity to meet accounting policies and Model Audit Rule Controls, Check deposit scanning and other Treasury tasks. Completion of monthly basic journal entries and general ledger account reconciliations Responsibilities Primary Job Responsibilities Perform daily b

The Manager works closely with their counterpart to assist the Senior Director, PACE Operations to manage the program level operational and regulatory functions related to Fallon Health's PACE programs. Responsible for compiling reports and analyzing data and making program level recommendations. T he Manager supports the Senior Director, PACE Operations to manage program

Respond to physician, hospital, ancillary provider inquiries and requests for services associated with the resolution of provider complaints relating to operational concerns, policy and procedures for Fallon Health products and subsidiaries. Understand Fallon Health policies and facilitate and the research required to resolve provider issues. Work collaboratively with int

The Medical Accounting Senior Accountant (MASA) is a strategic partner to management across the organization. The role requires proficiency in the development, accumulation, and evaluation of key elements necessary to properly report the financial position of the organization. The MASA is responsible to maintain the general ledger's accuracy by creating, processing and/or

Works closely with SE Site Director to provide day to day oversight of PACE operations for assigned PACE site of 400 or more participants. Responsible for coordination and supervision of all clinical staff, financial, and business aspects of a PACE team of 200 participants or more. Manages all administrative functions related to running a PACE center. Responsible for hiri

The FH authorization process is an essential function to FH's compliance with CMS regulations, NCQA standards, other applicable regulatory requirements, and customer expectations. The FH Authorization Coordinator serves to administer the FH prior authorization process as outlined in the Plan Member Handbook/Evidence of Coverage, departmental policies and procedures, and r

Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant's plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and di

Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant's plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and di

Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant's plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and di

Join the dynamic team of Enterprise Project Management Office (ePMO)! As a valued member of our team, you will be responsible for managing the life cycle of large cross functional projects that are of highest strategic priorities for Fallon Health. You will bring your project management talents to build relationships with key project stakeholders and external vendors and

As a Solution Architect, you will be responsible for aligning Fallon's business strategy with technology solutions to drive process improvement, competitive advantage, and innovation. You will engage business and IT stakeholders at all levels of the organization to understand the business strategy, capabilities and processes and use this data to identify and shape solutio