Top 322 Remote quality consultant Jobs in Lexington, Ma

Sr. Provider Relations Consultant
WellSense Health Plan —Boston, MA
- $69,500 - $101,000 a year
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Development Associate
East Boston Social Centers —Boston, MA
- $60,000 - $65,000 a year
- Temporary
- Hybrid work
- Background check
- Google Workspace
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
11d
Data Science Consultant - AI Trainer
DataAnnotation —Dedham, MA
- $50 - $100 an hour
- Part-time
- Remote
- Computer Science
- English
- Mid-level
- Flexible schedule
Quick Apply
13d
Principal SAP PaPM Configuration Engineer
Liberty Mutual —Boston, MA
- $120,000 - $225,000 a year
- Full-time
- Hybrid work
- Master's degree
- SQL
- Analysis skills
Supplier Quality Analyst
Noramtec Consultants Americas —Boston, MA
- From $35 an hour
- Contract
- Microsoft Word
- Background check
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
4d
Part-Time Registered Dietitian (50% remote)
RD Nutrition Consultants —Boston, MA
- $40 - $45 an hour
- Choose your own hours
- Hybrid work
- Skilled nursing facility
- Mid-level
- Master's degree
Quick Apply
1d
Sr. Mechanical Engineer - Site Development
Raytheon —Marlborough, MA
- $86,800 - $165,200 a year
- Full-time
- Schematics
- Office
- 3 years
- Paid holidays
- Disability insurance
2d
Engagement Manager (Remote)
GlideFast Consulting —Waltham, MA
- $115,000 - $160,000 a year
- Full-time
- Remote
- Mid-level
- Travel
- Fair chance
- Health insurance
- Dental insurance
Senior Technical Consultant (Remote)
GlideFast Consulting —Waltham, MA
- $130,000 - $170,000 a year
- Full-time
- Remote
- 3 years
- Travel
- Mentoring
- Health insurance
- Dental insurance
Technical Consultant (Remote)
GlideFast Consulting —Waltham, MA
- $100,000 - $140,000 a year
- Full-time
- Remote
- Mid-level
- Travel
- Scripting
- Health insurance
- Dental insurance
Project Manager I (remote)
Human Services Research Institute —Cambridge, MA
- $62,800 - $91,075 a year
- Full-time
- Remote
- 5 years
- Writing skills
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Implementation Consultant
List Engage —Framingham, MA
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
Supplier Quality Senior Specialist
Lantheus Medical Imaging Inc —Bedford, MA
- $111,000 - $185,000 a year
- Hybrid work
- Inventory management
- Bachelor of Science
- Databases
- Paid parental leave
- Paid holidays
Quick Apply
9d
Consultant I, Medical Writing
Syner-G —Boston, MA
- Hybrid work
- Microsoft Excel
- Mid-level
- Office
- Paid holidays
- Paid time off
Quick Apply
Consultant
Brown & Brown —Southborough, MA
- $100,000 - $125,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- 3 years
- Employee stock purchase plan
- Paid holidays
Project Manager II (remote)
Human Services Research Institute —Cambridge, MA
- $74,600 - $110,975 a year
- Full-time
- Remote
- 7 years
- Mid-level
- Master's degree
- Paid holidays
- Disability insurance
Quick Apply
Operations Consultant – Logistics/Freight Forwarding/Customs
Magaya Corporation —Boston, MA
- $70,000 - $100,000 a year
- Full-time
- Remote
- Mid-level
- JavaScript
- Travel
- Paid holidays
- Disability insurance
Quick Apply
Clinical Quality Assurance Coordinator
MES Solutions —Norwood, MA
- $27 - $29 an hour
- Full-time
- Remote
- Nursing
- Anatomy knowledge
- Microsoft Excel
- Dental insurance
- 401(k)
Quick Apply
4d
ERP Agile Transformation Delivery Consultant, Senior Associate
PRICE WATERHOUSE COOPERS —Boston, MA
- $77,000 - $202,000 a year
- Remote
- Mid-level
- 3 years
- Bachelor's degree
- Paid holidays
- Health insurance
3d
Senior Data Science Consultant, Insurance - Remote
CSAA Insurance Services, Inc. —Boston, MA
- $160,155 - $213,550 a year
- Full-time
- Remote
- 7 years
- Master's degree
- SQL
- 401(k) matching
11d

I want to receive the latest job alert for remote quality consultant in lexington, ma

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

remote quality consultant jobs near lexington, ma

Medical Consultant jobs in Boston, MA

Erp Consultant jobs in Boston, MA

Dietitian jobs in Boston, MA

Development Associate jobs in Boston, MA

Supplier Quality Engineer jobs in Boston, MA

Employee Relations Manager jobs in Boston, MA

Freight Forwarder jobs in Boston, MA

Data Scientist jobs in Boston, MA

Senior Mechanical Engineer jobs in Marlborough, MA

Project Manager jobs in Cambridge, MA

Senior Project Manager jobs in Cambridge, MA

Quality Assurance Coordinator jobs in Ann Arbor, MI

Mds Coordinator jobs in Cherry Hill, NJ

Quality Assurance Coordinator jobs in Houston, TX

Quality Assurance Remote jobs in Chicago, IL

Quality Assurance Coordinator jobs in Aurora, CO

Remote Quality Assurance jobs in Georgia

Quality Assurance Coordinator jobs in Fairfax, VA

Patient Care Coordinator jobs in Fort Worth, TX

Medical Reviewer jobs in New York, NY

Sr. Provider Relations Consultant

WellSense Health Plan -
Boston, MA

Apply Now

Job Details

Full-time
$69,500 - $101,000 a year

Benefits

Health insurance
Dental insurance
Flexible spending account
Paid time off
Vision insurance
403(b)
Opportunities for advancement

Qualifications

Employee relationship building

Full Job Description

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

Responsible for managing assigned territory of professional, institutional and ancillary providers to develop and enhance relationships, making WellSense Health Plan their plan of choice. Serves as the primary liaison between WellSense and key provider organizations, taking the lead and promoting collaboration within WellSense as it relates to provider satisfaction. Manages territory of assigned network partnerships, that may include Special Kids Special Care (SKSC) providers, HRSN (Health Related Social Needs) providers, primary care providers, specialists, facilities, community health centers, ancillary providers, and labs. Works closely with the Sr. Provider Relations Consultants and the Provider Relations Manager to identify issues and report trends.

Acts as the primary liaison between the providers and internal WellSense departments including Provider Enrollment, Member Enrollment, Member & Provider Services, Claims, Audit, Marketing, Utilization Management and Care Management.

Our Investment in You:

Full-time remote work

Competitive salaries

Excellent benefits

Key Functions/Responsibilities:

Develops and enhances relationships with assigned providers including ACO’s, HRSN’s, primary care providers, specialists, community health centers and hospital systems through effective business interactions and outreach.

Works collaboratively with Provider Relations Consultant team members and Manager to develop and update provider orientation programs

Coaches and assists in the training of Provider Relations Consultants and Provider Relations Specialists.

Organizes, prepares and conducts orientations of network providers (administrative and clinical) and their staff. Takes the lead on specific WellSense initiatives as they relate to provider education.

Develops provider presentations that clearly communicate plan information and updates. Delivers presentations to provider groups, health systems, and provider forums.

Provides guidance and support on plan products and policies to providers and coordinates office and provider site meetings.

Meets with assigned providers regularly according to site visit servicing standards. Documents all pertinent provider communications and meeting notes in customer relationship portal.

Acts as liaison for all reimbursement, credentialing, claims, portal procedures and issues of assigned providers. Facilitates resolution of complex contractual and member and provider issues, collaborating with internal departments as necessary.

Works collaboratively with Contract Managers in implementing and administering contractual provisions of provider agreement to ensure contractual compliance. Monitors contractual compliance on an on-going basis.

Assists in the implementation of new provider contracts as needed so providers can be credentialed, loaded in systems timely and correctly, and notified within standards set by department.

Manages flow of information to and from provider offices. Ensures active provider contacts are kept up to date for effective mailing and communication.

Outreaches to providers to support WellSense initiatives, assigned projects and/or member grievances.

Analyzes operational issues related to territory and provider operations and includes other internal departments as necessary.

Facilitates timely problem resolution. Initiates interdepartmental collaboration to resolve complex provider issues.

Identifies system updates needed and completes research related to provider data.

Represents Provider Engagement and WellSense at external provider and community events to maintain visible presence

Produces reports as needed to support provider education, servicing, credentialing and provider network maintenance.

Ensures quality and compliance with state Medicaid regulations and NCQA requirements.

Other responsibilities as assigned.

Regular and reliable attendance is required.

Supervision Exercised:

Does not directly supervise staff. May provide technical supervision and support to less experienced staff as needed.

Supervision Received:

Indirect supervision is received weekly.

Qualifications:

Education:

Bachelor’s degree in business administration or a related field or an equivalent combination of education, training and provider relations or network management experience is required.

Experience:

4 or more years of progressively responsible experience in provider relations or network management required.

Preferred/Desirable:

Experience in the Medicare provider healthcare insurance industry

Certification or Conditions of Employment:

Successful completion of pre-employment background check

Competencies, Skills, and Attributes:

Knowledge or familiarity with Medicaid and Medicare is a plus

Understanding the provider community

Proven demonstration of effective communication skills (verbal and written), and interpersonal skills

Demonstrated ability to establish, build and maintain relationships with internal and external constituents

Strong analytical, research and organizational skills

Strong follow up skills a must

Ability to think and react quickly to address questions and issues while interacting with the provider community

Foster an atmosphere of collaboration and teamwork internally and externally

Demonstrate initiative, judgment, discretion and ability to operate within politically sensitive framework

Ability to be flexible, work independently and manage multiple tasks

Demonstrated competence using Microsoft Office products especially Excel and Access, familiarity with FACETS helpful

Demonstrated competence using Microsoft Office products especially Word, Excel, Outlook, Access, PowerPoint. Experience or knowledge of FACETS.

Ability to set and manage priorities, thrive in a fast paced environment, multitask, be pro-active, and think outside the box to solve complex problems.

Working Conditions and Physical Effort:

In office work performed in a typical remote home office environment.

Must be willing to travel to assigned providers for servicing to meet business needs up to 50% of time.

Must be able to travel to multiple provider offices across a wide geographic area on a regular basis, often within the same day.

Compensation Range

$69,500 - $101,000

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Note: This range is based on Boston-area data, and is subject to modification based on geographic location.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Apply Now

Refine Your Search

remote quality consultant jobs in lexington, ma

Sr. Provider Relations Consultant

Development Associate

Data Science Consultant - AI Trainer

Principal SAP PaPM Configuration Engineer

Supplier Quality Analyst

Part-Time Registered Dietitian (50% remote)

Sr. Mechanical Engineer - Site Development

Engagement Manager (Remote)

Senior Technical Consultant (Remote)

Technical Consultant (Remote)

Project Manager I (remote)

Implementation Consultant

Supplier Quality Senior Specialist

Consultant I, Medical Writing

Consultant

Project Manager II (remote)

Operations Consultant – Logistics/Freight Forwarding/Customs

Clinical Quality Assurance Coordinator

ERP Agile Transformation Delivery Consultant, Senior Associate

Senior Data Science Consultant, Insurance - Remote

I want to receive the latest job alert for remote quality consultant in lexington, ma

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected