Fallon Health jobs in Springfield, MA

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 top health plans for member experience, service, and clinical quality. Fallon Health's NaviCare is a program for people age 65 and older, who live in our service area, and who have MassHealth Standard, and may have Medicare. It combines MassHealth (Medicaid) and Medicare benefits, including prescription drug coverage. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope , we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region. Brief summary of purpose: This position requires that the Account Executive achieves personal referral and outreach goals for the NaviCare program. Manages a territory and group of referral source accounts, providing regular follow up and overcoming barriers with each account to meet enrollment goals. Responsibilities Primary Job Responsibilities: 1.Relationship Building Creates productive and collaborative relationships with internal and external referral sources in order to obtain qualified referrals and enrollments for the NaviCare program. Participates in all community outreach activities, such as senior fairs, community events, and elder services professional association events to ensure Fallon Health's visibility and presence in your territory. Presents the NaviCare program to groups who are likely prospects, caregivers and community referral sources. Develops and implements their own territory business development plan and carries out activities to penetrate accounts listed on the plan. 2.Lead Generation Works collaboratively with Navicare enrollment team to discuss progress of referrals and ideas for resolving issues. Provides inservice orientations to vendors and providers on an annual basis. Shows accountability and follows up with prospects until the lead is closed/withdrawn and document as appropriate. Achieves monthly referral and home visit request goals 3.Secure Applications Generates sufficient NaviCare enrollment applications to meet monthly enrollment goals. Explains the NaviCare program clearly and consistently to prospects and their families to ensure that prospects enroll with a solid understanding of the program maintaining a low disenrollment rate. Meets with NaviCare prospects in their homes. Completes application and other documentation needed. Submits all completed applications in a timely manner as required by CMS. 4.Tracking & Reporting Documents all sales activities in the department's CRM application and account management grid in a timely manner. Meets weekly sales activity deliverables consistently, and tracks these in the CRM and their Outlook calendar. Maintains records of NaviCare applications and documentation related to scope of appointments. 5.Assessment Regularly reviews effectiveness of efforts against goals. Provides market intelligence to the NaviCare/ Manager and the Outreach Director so that adjustments can be made to tactical plans. Manages their own professional development by seeking advice, training, and coaching from their colleagues, manager, and the Director of Outreach. 6.Regulatory Guidelines Operates within the marketing and outreach guidelines and regulations provided by CMS and EOHHS. Retains Scope of Appointment and other Enrollment Records. Submits information on NaviCare prospect events to Outreach Support in a timely manner, for CMS submission. When in doubt, asks questions pertaining to compliance or privacy regulations. Must meet monthly, quarterly and year end enrollment goals. Must maintain a mininimum number of activites and event designed to generate leads for enrollments. Must keep up to date all records related to leads in CRM system, Account Management Grid and any other report requested by your manager. Must cause to have at minimum 10 actively referring account. Must work to develop at least 10 new accounts every month. Must attend all required Department and collaborating Department meetings. Must complete and deliver on time reports, documentation, and yearly business plan for your territory. Qualifications Education, BS or BA degree and/or comparable experience Certification and Licenses: Must have or obtain within 90 days of hire date Massachusetts Insurance Producer License Obtain AHIP certification before or after hire Experience: Knowledge and experience working with community organizations, low income communities and the elderly 3 years of sales experience in healthcare or group insurance strongly preferred. Must have proven experience working in a customer facing role focused on sales, lead generation in a high paced customer service or sales environment. Knowledge of Medicare, Medicaid and insurance products is desirable. Knowledge of customer service, sales, outreach and marketing principles and practices. Possession of a valid Mass. driver's license and a vehicle to be used for marketing activities and home visits. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $65,000 - $70,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P02 Not Ready to Apply? Join our Talent Community now!

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with CMS regulations, CMS 5 Stars, NCQA standards, other applicable regulatory requirements and member and provider expectations. The FH Appeals and Grievances Triage Administrator serves to administer the FH Appeals and Grievance process as outlined in the FH Member Handbook/Evidence of Coverage, departmental policies and procedures, and regulatory standards. The Triage Administrator is responsible for triaging and assigning all incoming appeals and grievances addressed to the Member Appeals & Grievances Department and Provider Appeals Department. This position will also provide administrative support to the departments. Serves as liaison between Fallon Health members and contracted providers regarding appeals and grievances. Responsibilities Primary Job Responsibilities * This position is divided equally between Member Appeals and Grievances Department and Provider Appeals Department with 20 hours dedicated to each department per week. * Act as the initial investigator and contact person for grievances and appeals, which includes, sending the appropriate acknowledgement of the grievance/appeal, educating the member and/or member representative about the grievance/appeal, gathering all pertinent and relevant information from the member regarding the grievance/appeal. * Acts as the initial investigator for provider appeals related to filing limit, claim denials, claim payment, retrospective referrals, administrative inpatient days and other issues for which the provider is liable. * Responsible for processing all incoming mail, as well as forwarding all initial claim submissions, claim adjustments, and other miscellaneous mail to appropriate departments. Managing incoming faxes, emails, voicemails and member/provider specific data, routing to the appropriate staff member. * Identifying the need for Personal Representative Authorization form, Medical Record Release Authorization form, or Provider Payment Waiver form and requests such documentation as necessary. * Assigning case files to the department staff for appeal/grievance management. * Providing administrative assistance in support of the Board of Hearings (BOH) process, including preparation of hearing packets, reviewing of materials, as well as tracking and monitoring hearing decisions. * Ensure that all grievances/appeals are processed in adherence to state and federal regulations (i.e., CMS, MassHealth, OPP), contractual obligations, NCQA guidelines and FH policy. * Processing of reports which produce all correspondence to providers related to appeal determinations and untimely requests, as well as sending those correspondence to providers. * Filing of individual provider appeals files in accordance with department standards. Maintain provider appeal database and analyze data to assist provider appeal coordinators in production of monthly reports forwarded to management. * Print and mail letters at the FH corporate office located at 1 Mercantile Street, Worcester, MA several times per month or as needed, as designated through a rotational in-office calendar or at the direction of a supervisor or manager. Qualifications Education High School Diploma License/Certification Reliable Transportation required Experience Minimum 2 years' experience in the operational side of a healthcare or insurance organization preferred. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $21 - $22/hour, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Join a Mission-Driven Team at Fallon Health Summit ElderCare! * Locations: Worcester, Leominster, Lowell, Springfield, Webster, Dartmouth - come take a tour and meet the team! Primary Care Physician - PACE Program * Salary Range: $275,000-$300,000/year, based on skills and experience. At Fallon Health, we don't just offer jobs-we offer purpose. As part of our Summit ElderCare PACE program, you'll be at the forefront of a growing, innovative model of care that helps older adults live safely and independently at home. If you're passionate about quality over quantity, enjoy working in a collaborative interdisciplinary team, and want to make a real difference in the lives of frail elders, this is the opportunity for you. * Work-Life Balance: Monday-Friday, 8-hour days with a flexible schedule, and an optional administrative day with no direct patient care. * Patient-centered Care: See an average of 4 patients per day, with an average panel of 65, allowing time for more meaningful care. * Team-based Culture: Work alongside a dedicated interdisciplinary team of geriatric care professionals * Mentorship & Growth: Benefit from strong peer mentorship and leadership support * Mission-driven Work: Help frail elders avoid nursing home placement and live with dignity in the community "PACE is the future of elder care-and Fallon Health is leading the way. If you're looking for a career where your time, expertise, and compassion truly matter, Summit ElderCare is the place to be." About us: Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Overview:The team uses a collaborative approach to care planning and is called the Interdisciplinary Team (IDT). The IDT is comprised of Providers (MD/DO and NP/PA), Nurses, Social Workers, Physical and Occupational Therapists, Dieticians, Health Aides, Recreation staff, Home Care and Transportation Coordinators and Site Administrator. This approach to care is the gold standard for complex and frail older adults who wish to avoid nursing home placement. Responsibilities Highlights of Summit ElderCare * Provide compassionate, individualized primary care in clinic, home, and SNF settings. * Deliver care for patients with the full support of your interdisciplinary team (IDT) of primary nurse, social worker, dietitian, physical and occupational therapists, life enrichment specialist, home care nurse, health aide, business office personnel, and others. * Coordinate care with specialty consultants * Engage with patients and caregivers to support a Whole-person care approach * Participate in quality improvement and educational initiatives Qualifications * MD or DO licensed in Massachusetts * Board Certification in Internal Medicine, Family Practice, or Geriatrics (preferred) * DEA certification * 1+ year experience with frail or elderly populations * Passion for team-based, patient-centered care Pay Range Disclosure: * In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $275,000 to $300,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. This position requires permanent work authorization in the U.S. We will not provide visa sponsorship or accept candidates on OPT/CPT for this role. Brief Summary of Purpose: Seeking a motivated and detail-oriented analyst to join our team. This position is ideal for candidates who have passed at least two actuarial exams and are eager to apply their analytical skills to support key business functions such as pricing, reserving, forecasting, and risk analysis. Responsibilities Primary Job Responsibilities * Assist in the development and maintenance of actuarial models for valuation, forecasting, pricing, and/or risk analysis * Perform data analysis and experience studies using large datasets from internal and external sources * Support the preparation of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses * Collaborate with cross-functional teams including finance, claims, sales, and product development to evaluate the impact of benefit changes, provider contracts, and regulatory updates * Document assumptions, methodologies, and results in compliance with ASOPs, CMS guidance, and state/federal requirements * Contribute to the automation and streamlining of actuarial processes * Stay current with industry trends, regulatory changes, and professional standards Qualifications Education: BS or BA in Actuarial Science, Mathematics, Statistics, Finance, Economics or related field. License/Certifications: Passage of at least two Society of Actuaries exam is required. Experience: The ideal candidate must possess: * Excellent quantitative, problem-solving, and analytical skills * Attention to details and ability to learn quickly * Well-developed oral and written communication skills * Ability to work independently and as part of a team * Proficiency in Excel; experience with actuarial software (e.g. - SAS, SQL, Python, VBA) is a plus * Familiarity with insurance products and regulatory environments * Commitment to pursuing actuarial credentials with the Society of Actuaries and professional development Pay Range Disclosure:In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $85,000 to $ 90,000 , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: Under the direction of the Manager's, the Eligibility and Revenue Operations Representative supports Fallon Health's mission, vision and values by providing and maintaining timely and accurate enrollment and billing information. Documents pertinent information enabling tracking of group/subscriber/member and eligibility and adheres to internal and external SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage, Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health Weinberg and any future regulatory products is entered into Fallon Health's core system. Completes work accurately and timely to remain in compliance with DOI, CMS and EOHHS regulations. Appropriately escalates concerns when necessary and follows issues through to closure. Reviews problems not clearly defined by written directives or instructions with the Eligibility and Revenue Operations Coordinator, Senior Financial Support or Manager to determine course of action. The Eligibility and Revenue Operations Representative collaborates effectively with co-workers and other departments to ensure quality service to our internal and external customers. Interacts with departments such as Accounting, Sales, and Regulatory Affairs. Maintains a positive approach to issues and concerns as they arise and works to identify and recommend process improvements to his/her direct manager. Responsible for ensuring the integrity of information being entered & maintained within the core system (QNXT, TruCare, EOHHS, Trackers, etc) Must have the ability to analyze various situations and be able to make independent decisions on best practices in the interest of the members and the health plan. The Eligibility and Revenue Operations Representative will assist the Management team with projects and/or daily workload for all regulatory products. Assist Account & Provider Configuration in working updates needed in sponsor configuration. This is handled through working DI reports. Pre-requisites for success in this position include Strong verbal & written communication skills including demonstrated excellence in telephone communication skills, strong organizational skills, computer skills. Performs all functions necessary to maintain accurate subsidiary accounts receivable and ensures accuracy of premium bills. Analyze/reconcile receivables balance for Commercial and Regulatory products to identify problems with payments and/or impose the delinquency process. Study the contractual terms and conditions to ensure payments received meet the contractual requirements. Handles confidential customer information. Knowledgeable of plan policies, protocols, and procedures. Requires ability to work in a fast-paced environment with multi-disciplined staff. Consistently follows through on issue resolution. Strong multitasking abilities are essential along with taking accountability and understanding job functions can change based upon business needs. Initiates self-development via available company and industry educational opportunities The Eligibility and Revenue Operations Representative is responsible for enrollment and billing maintenance, adhering to daily, weekly and monthly schedules and administrative related tasks. Responsibilities Primary Job Responsibilities: Works proactively to ensure the enrollment and billing records are kept current and accurate. Ensures goals and turnaround standards are being met or exceeded based on corporate and departmental metrics.Responsible for maintaining up to date primary care physician assignments in core system accurately and timely. This is to be completed through review of data integrity reports, and working closely with Provider Partners, Provider Relations, Contracting and Account and Provider Configuration.Maintains professional etiquette and positively represents Fallon Health when meeting in-person with customers for eligibility and premium related inquiries.Enters and maintains data in the E&B tracker in a timely and accuarte fashion to to be utilized with the required reporting from CMS and EOHHS.Assists with core system upgrade testing Assists in creating/maintaining desk top procedures and P&P'sAssists Management team on audit responses and/or site visits Participates in departmental and company-wide process improvement projects, training, upgrade testing and team meetings as assigned.Performs other duties as they are assigned to meet department performance goals and to respond to changing priorities including administrative related tasks.Works department returned mail Quality control of enrollment and billing processes for accuracy and compliance to established policies and procedures.Responsible for maintaining up to date productivity records on a daily and monthly basis for corporate and departmental dashboards.Ensure adherence to documented payment plans Qualifications Education: Education: High School diploma required; bachelor's degree preferred License/Certifications: Experience: 4 plus years' experience in an office environment, preferably in health care and/or managed care system Strong analytical and problem-solving skills Aptitude towards mathematical fundamentals Flexibility in a fast-paced environment.Excellent Organizational skills/time management Strong focus on quality & performance results Systems knowledge including but not limited to MS Excel, MS Word, MS Access.Ability to effectively communicate, both written and verbal.Builds Relationships/contributes to team performance Adhere to all DOI, State, and Federal guidelines Pay Range Disclosure:In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 25.00 per hour which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: 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 customers, manage all phases of the projects, and deliver measurable results. Collaborating with a broad group of stakeholders, Project Manager III will ensure appropriate business objectives are defined and will apply their experience and industry-standard practices to manage project activities, communicating effectively with project sponsors, business, and technology partners. Key deliverables include successful execution and project delivery quality that is constrained by project scope, cost and time, delivery on project success criteria, ensure high quality project documentation and reporting, as well as proactive risk mitigation and conflict resolution, while fostering relationships to promote cross-collaboration and positive culture. Responsibilities Primary Job Responsibilities: Leads the planning, execution and monitoring of assigned projects adhering to project management methodologies, ePMO established project management lifecycle, standards and best practices Drives the execution of one or more strategic project(s) of various complexity and significant cross-functional impact with multiple stakeholders Defines and documents project scope, objectives, deliverables and success criteria in collaboration with varies stakeholders across the enterprise Facilitates project kick-off, establish project governance, project team workshops and meetings Develops project plans, timelines and project resource schedules Manages project budget, vendor Statement of Work (SOW), purchase orders (PO) and invoices related to project costs Identifies, communicates and manages project risks, issues and dependencies and develops mitigation strategies and plans Communicates project status and key milestones to stakeholders, providing timely and regular updates through reporting and presentations Interact closely with multiple internal and external parties, including vendors Conducts post project lessons learned, documents areas of improvements and applies to future projects Supports the ePMO with departmental initiatives and projects, share best practices and project management skills to optimize ePMO capabilities Provides coaching, support and guidance to other project managers and project team members Other projects and duties as assigned Qualifications Education: Bachelor's Degree required. License/Certifications PMP Certification preferred Experience: 5 to 8 years of Project Management experience. Health plan experience is a plus PMP Certification is a plus Demonstrated experience of successfully leading complex cross functional business and technology implementations Advanced knowledge with PMP tools, techniques and project development methodologies and Project Life Cycle Ability to comprehend and communicate complex information written and verbal in varied formats to internal and external customers Ability to lead and direct multiple teams for large projects or groups across functional areas, assign accountability, while promoting and fostering teamwork, collaboration and a positive work environment Demonstrate strong leadership and interpersonal skills Ability to develop and deliver effective presentations Outstanding communication, organization and influencing skills Ability to navigate complex projects and respond quickly to changing issues and priorities involving multiple departments and stakeholders Advanced skills with Microsoft applications, such as Project Management tools, Word, Excel, PowerPoint, Visio and other web-based applications. May produce complex documents and produce analysis Project Management Body of Knowledge (PMBOK) Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $125,000 - $135,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Not Ready to Apply? Join our Talent Community now!

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 top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region. Brief summary of purpose: Functions as a member of the PACE Interdisciplinary Team and provides social work services and support to participants, families, and other caregivers. Provides direction to bachelor's level social workers as assigned by Social Work Manager. Why should I consider a Social Work opportunity in a PACE program at Summit? Great Pay! LICSW supervision offered to advance licensure. Anchor position Great Benefits - including very affordable Health Insurance! 23 days of PTO - and - an additional 12 Holidays Monday to Friday from 8:30 AM - 5:00 PM No Holidays! Some wonderful relationships established with the participants you care for! Manage a caseload of only 65 participants in collaboration with your team which includes a provider and primary care nurse. Assessments completed only semi-annually or for a significant change Assist with the supervision and training of MSW student interns And many, many more! Responsibilities Primary Job Responsibilities: • Participates in the intake and evaluation process by conducting the initial social work assessment, administering MSQs, developing an intake summary and presenting the social work perspective to the interdisciplinary Team. • Assures that participants rights are reviewed during the intake process. • Conducts reassessments at least semiannually and whenever there is a change in participant status or the participant /caregiver requests it. • Develops and implements a social service plan of care for each participant and updates it based on the results of reassessments or on-going changes in status. • Responsible for the maintenance of appropriate records and documentation in the medical record including at least the initial assessment, quarterly progress notes, significant changes and all participant-related interactions. • Participates as a member of the Interdisciplinary Team at daily team meetings and care planning meetings. • Assists team members to understand the social, emotional, cultural and psychosocial aspecst of participants' situations. • Acts as an advocate and liaison when counseling services are needed. • Completes documentation and record-keeping related to disenrollment's, deaths and permanent placement; distributes relevant notifications. • Participates in the development, promotion and implementation of caregiver support groups or programs; leads or co-leads groups as necessary. • Assists in managing referral telephone calls as needed. • Implements program policies and procedures as directed. • Assists in the conversion of participants from community based Medicaid to long-term care Medicaid when necessary. Works collaboratively with the Operations Support Representative to assure appropriate access to Medicaid benefits. • Pursues relevant professional development. Attends appropriate workshops and in-service activities to maintain current professional status. • Consistently follows the Social Work Code of Ethics. • Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Qualifications Education: Master's degree in social work License/Certifications: Valid and unrestricted license to practice social work from the Board of Registration of Social Work of the Commonwealth of Massachusetts. Access to reliable transportation to perform work throughout the PACE center's service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage Experience: At least two years experience in a Social Work capacity, preferably in a community setting, with a minimum of one year experience working with a frail or elderly population. Generally, establishes own work plan and priorities, using and/or modifying established procedures, to assure timely completion of assigned work in conformance with program policies and standards; problems lacking in clear precedent are reviewed with Manager prior to acting. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 85,000, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01 Not Ready to Apply? Join our Talent Community now!

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief of Summary of Purpose: Responsible for processing, verifying, and reconciling Accounts Payable invoices. Responsibilities Primary Job Responsibilities: AP processing for FCHP and overall functionality of Oracle AP Enter/Scan all accounts payable invoices into Oracle and analyze and pay vendor accounts according to invoice terms, either PO or GL account costing Ensure AP invoice and backup approvals attached to payment Assist with AP inquires Assist with incoming mail, distribute accordingly Upload other multi line AP requests into Oracle Financials / Record all ACH/Wire payments Submits payment to bank, confirms positive pay Assist with requests from Internal Audit with Model Audit requests Assist the Director of accounting Operations with ad hoc projects Qualifications Education: Associate degree in accounting or equivalent work experience. Experience: 1-2 Years' experience working in an accounting dept- specific Accounts Payable processing preferred. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 55,000 which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Not Ready to Apply? Join our Talent Community now!

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 top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region. Summary of purpose: Provides program level guidance and recommendations relevant to the provision of clinical and nursing services. Oversees implementation of discipline specific policies and procedures. Responsible for the operations of the PACE center clinic. Oversees all nursing services provided to the participants at the center. Supervises and directs RNs, LPNs and Health Aides assigned to the ADHC. Functions as the Assistant Program Director as needed/assigned. Responsibilities Primary Job Responsibilities: Assists with recruitment and training of staff within the discipline. Participates in the oversight of related contracted vendors. Monitors PACE, ADHC and state discipline specific regulations to identify, communicate and when appropriate, implement needed changes. Represents the program and related discipline at assigned community and external events upon request. Develops and maintain discipline specific competency tools. Coordinates the provision of patient care throughout the clinic. Collaborates with participants, caregivers, physicians, nurse practitioners and other staff to meet participants' needs. Delegates work to nursing staff members according to their scope of practice by establishing work assignments and coordinating staff schedules. Participates in all types of Interdisciplinary Team meetings. Participates in management and quality meetings as required. Collaborates with the Site Director to establish goals and objectives related to the clinical setting. Coordinates/supervises the purchase of medical/surgical/pharmaceutical supplies. Assures that clinical equipment is in good working condition in collaboration with the Quality and Risk Manager. Assumes responsibility for inservice education for nursing staff. Interviews potential nursing staff candidates and makes recommendations for hiring to Site Director. Conducts new staff orientation and performance evaluations for clinical staff in a timely manner. Conducts regular staff meetings with clinical staff. Assists with routine nursing duties as required. Assures that corrective action plans are completed for incidents related to clinical services. Assists the Site Director to carry out administrative duties as needed. Functions as acting Site Director in the Site Director's absence. Accepts “on-call” duty on a rotating basis and assists the Site Director with scheduling the rotation. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Oversees site RN On Call rotation and Process; ensures RN coverage for on call Qualifications Education Graduate of an accredited school of nursing. A Bachelor of Science in Nursing is strongly preferred. License/Certifications License: License to practice as an RN in the State of Massachusetts Access to reliable transportation to perform work throughout the PACE center's service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage. Certification: CPR certification or willingness to be certified Experience At least two years of managerial experience working with frail elders in a healthcare setting. Ambulatory clinic experience is helpful but not essential. Possesses nursing assessment skills Ability to work within an interdisciplinary team model Knowledge of the nursing care planning process. IV skills are helpful but not essential. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is between $125,000 - $127,00 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01 Not Ready to Apply? Join our Talent Community now!

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief Summary of Purpose: Under the direction of the Market Research Manager, supports Fallon by making Welcome/Outreach calls to members and/or survey calls to members or providers. Handles confidential patient/member information. Uses strong verbal communication skills and demonstrates excellent telephone communication skills. Understands the importance of leaving a positive impression on any member with whom they come into contact. When necessary, assists member through the creation of formal research cases. Responsibilities Job Responsibilities: * Exhibits courtesy, compassion, empathy, and respect in all outbound communications with members and providers. Utilizes proper judgment in handling difficult or unusual calls. * Responsible for learning and keeping current with Fallon products, policies and procedures. * Responsible for documenting the results of all outbound calls using an electronic or written form. * Makes Welcome/Outreach telephone calls to Fallon members providing product knowledge, customer assistance, and problem solving. * Administers member telephone surveys. Working from a script, asks both open-ended and closed ended questions of members in order to capture information such as why the member joined Fallon, how satisfied the member is with Fallon and why the member left Fallon. * Maintains the highest degree of member/patient confidentiality. * Works both as a team member and as an individual depending on assigned project. * Works on special projects and other tasks such as focus group recruitment and data entry as assigned by the Market Research Managers or executive staff. * Assists Fallon members by creating formal research cases. When necessary, is responsible for properly documenting member issues and entering information into a specialized company database. Competencies: * Adaptability - Handles day-to-day work challenges confidently. Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change. Shows resilience in the face of constraints, frustrations or adversity. Demonstrates flexibility * Perseverance - Pursues everything with energy and drive and a need to finish. Seldom gives up before finishing, especially in the face of resistance or setbacks. * Problem solving - Solves difficult problems with effective solutions. Asks good questions. Can see underlying or hidden problems and patterns. Is excellent at honest analysis. Looks beyond the obvious. Independent Action: * Duties are generally procedural, allowing the individual to perform independently with intermittent supervision, in conformance with written instructions, established timeframes, and predetermined priorities. Problems not clearly defined by written directions or instructions are reviewed with Market Research Manager to determine course of action. Qualifications Education: High School Diploma License/Certifications: N/A Experience: * Minimum of one year Customer Service experience in a call center environment * Computer skills Pay Range Disclosure: * In accordance with the Massachusetts Wage Transparency Act, the pay rate for this position is $19.50 per hour, which reflects what we reasonably and in good faith expect to pay at the time of posting. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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 top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region. Brief summary of purpose: Under the direction of the SE Site Director, the Dietitian is responsible for the provision and coordination of nutritional care of patients. Evaluates and interprets current nutrition research and disseminates this information to patients, support staff and healthcare providers. Develops and conducts nutrition education programs for patients, staff, community organizations and the local business community. Responsibilities Performs nutrition assessments, evaluation and education for patient base Demonstrates proficiency in age/condition specific appropriate nutrition history taking including presenting condition, past medical/nutritional history. Performs assessment of client's readiness for change and adjusts education goals as appropriate. Requests lab studies when indicated. Discriminates between normal and abnormal lab findings in order to develop nutrition education plan. Establishes plan of nutrition care related to patient's identified problem, including medication, nutrition history, education level and socioeconomic status, etc. Consults with other health care team members regarding nutrition care plan as necessary. Implements plan in safe and effective manner. Documents visit in concise, clear, logical manner. Evaluates need and/or time for follow-up. Recommends appropriate referrals when necessary. Evaluates effectiveness of previously implemented nutrition education/treatment. Develops and provides educational materials and/or programs to patients, families, healthcare professionals. Interprets current nutrition research for patients and healthcare staff. Accepts responsibility for minimizing risk management. Educates patients and staff regarding drug-nutrient interaction. Alerts appropriate medical staff of need for immediate intervention of high-risk patients. Initiates and coordinates team meeting for high-risk patients. Enhances professional growth and self-development through participation in professional activities, educational programs, current literature review, in-service program, and workshops. Participates in defining nutrition standards, practices and educational needs of staff who care for the patient population. Participates in nutrition research. Serves on appropriate healthcare system committees. Provides cross-coverage for other SE sites as needed to cover absences, etc. Develops and conducts continuing education programs for healthcare providers. Complies with health and safety requirements and with regulatory agencies such as DPH, etc. Complies with established departmental policies, procedures, and objectives. Enhances professional growth and development through educational programs, seminars, etc. Attends a variety of meetings, conferences, and seminars as required or directed. Performs other similar and related duties as required or directed. Qualifications Education: Masters degree in nutrition specialty from an accredited college/university preferred. Licenses/Certifications: Active R.D. status with the American Dietetic Association and Valid Driver's License and Clean Driving Record Required Experience: 1-3 years nutrition experience in a health care facility or company/ Proven experience developing and conducting group nutrition programs Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01 Not Ready to Apply? Join our Talent Community now!

This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + Great benefits! Full-time benefits offering! Health Insurance offerings! Paid Time Off! 12 Holidays! 401K Savings Plan! Tuition Assistance! Vision Care, Life Insurance and more!! + $20/hr to start and far exceeds state pay average! + Extra pay for shifts outside normal workday! Extra $3.50/hr weekdays between 7pm and 7am Monday through Friday (shift ends Friday at 7am) Extra $4.00/hr for weekends beginning at 7pm on Friday and ending 7am on Monday. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About Fallon Health Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org. About Summit ElderCare: Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon's PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities. Summary: 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 disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants' homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants' motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants' homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants' homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Not Ready to Apply? Join our Talent Community now!

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief Summary of Purpose: Under the direction of the Market Research Manager, supports Fallon by making Welcome/Outreach calls to members and/or survey calls to members or providers. Handles confidential patient/member information. Uses strong verbal communication skills and demonstrates excellent telephone communication skills. Understands the importance of leaving a positive impression on any member with whom they come into contact. When necessary, assists member through the creation of formal research cases. Responsibilities Job Responsibilities: Exhibits courtesy, compassion, empathy, and respect in all outbound communications with members and providers. Utilizes proper judgment in handling difficult or unusual calls. Responsible for learning and keeping current with Fallon products, policies and procedures. Responsible for documenting the results of all outbound calls using an electronic or written form. Makes Welcome/Outreach telephone calls to Fallon members providing product knowledge, customer assistance, and problem solving. Administers member telephone surveys. Working from a script, asks both open-ended and closed ended questions of members in order to capture information such as why the member joined Fallon, how satisfied the member is with Fallon and why the member left Fallon. Maintains the highest degree of member/patient confidentiality. Works both as a team member and as an individual depending on assigned project. Works on special projects and other tasks such as focus group recruitment and data entry as assigned by the Market Research Managers or executive staff. Assists Fallon members by creating formal research cases. When necessary, is responsible for properly documenting member issues and entering information into a specialized company database. Competencies: Adaptability - Handles day-to-day work challenges confidently. Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change. Shows resilience in the face of constraints, frustrations or adversity. Demonstrates flexibility Perseverance - Pursues everything with energy and drive and a need to finish. Seldom gives up before finishing, especially in the face of resistance or setbacks. Problem solving - Solves difficult problems with effective solutions. Asks good questions. Can see underlying or hidden problems and patterns. Is excellent at honest analysis. Looks beyond the obvious. Independent Action: Duties are generally procedural, allowing the individual to perform independently with intermittent supervision, in conformance with written instructions, established timeframes, and predetermined priorities. Problems not clearly defined by written directions or instructions are reviewed with Market Research Manager to determine course of action. Qualifications Education: High School Diploma License/Certifications: N/A Experience: Minimum of one year Customer Service experience in a call center environment Computer skills Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay rate for this position is $19.50 per hour, which reflects what we reasonably and in good faith expect to pay at the time of posting. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P03 Not Ready to Apply? Join our Talent Community now!

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 top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region. Brief Summary of Purpose: Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. Responsibilities Responsibilities: Reviews and implements Provider's orders. Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated. Involves participants and significant other(s) based on needs and abilities. Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards. Provides for cultural and diverse needs of participants when providing care. Monitors and evaluates therapeutic interventions. Participates in the development and ongoing review of each participant's care plan. Delegates participants' care responsibilities to other members of the health care team, when appropriate. Identifies emergency situations and initiates appropriate nursing orders/interventions. Meets the needs of participants in a timely manner. Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses' notes and health care teaching in the medical record. Participates in training and orientation of new nursing staff as assigned. Assists in the delivery of other nursing services as assigned. Participates in the nursing “on-call” rotation as assigned. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Participates in Weekend RN On Call rotation Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Current license as an LPN in the state of Massachusetts CPR and Alzheimer's certification, or willingness to be certified within 60 days of hire, is essential. Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population Ambulatory care or home care experience helpful. Competencies: Demonstrates commitment to the Fallon Community Health Plan Mission, Values and Vision. Specific competencies essential to this position: Customer Focus Commitment Through Action Contributes to Team Performance Focus Upon Quality Other: Reliable Transportation Required. COVID-19 Vaccination: With the end of the Global Coronavirus COVID-19 Pandemic, Fallon Health no longer requires all employees to be vaccinated against COVID-19 except for employees who are in jobs that under state and federal laws, regulations and policies are required to be vaccinated and/or they are in Member/participant facing positions. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01 Not Ready to Apply? Join our Talent Community now!

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 top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region. Brief Summary of purpose Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. Responsibilities Primary Job Responsibilities * Primary nurse not only has the responsibility for the participant, but the authority to advocate for the best care for the participant unique to their situation. * Fostering a relationship with the caregiver and participant. * Primary Nurse will take on a Leadership Role. * Effectively communicate with the healthcare team. * Assigns tasks and duties to the healthcare team; ensure the tasks are completed; responsible for their panel. * Develops an individualized plan of care. * Accountability for assessments, communicating needs and coordinating the care team. * Primary nurse develops the plan of care * Reviews and implements Provider's orders. * Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated. * Involves participants and significant other(s) based on needs and abilities. * Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards. * Provides for cultural and diverse needs of participants when providing care. * Monitors and evaluates therapeutic interventions. * Delegates and or accepts participants' care responsibilities to other members of the health care team, when appropriate. * Identifies emergency situations and initiates appropriate nursing orders/interventions. * Meets the needs of participants in a timely manner. * Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. * Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses' notes and health care teaching in the medical record. * Participates in training and orientation of new nursing staff as assigned. * Assists in the delivery of other nursing services as assigned. * Participates in the nursing "on-call" rotation as assigned. * Initiates and completes falls, infection, grievance and incident reports * Participates in CMS calls when deemed necessary. * Active participant in the site specific committees. * Participates in the post IDT huddle and any other additional meetings * Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director. * Assumes the role of the home care nurse, floor or triage nurse per the direction of the Clinical Nurse Manager or Site Director as appropriate. * Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. * Functions independently to administer medications and treatments as ordered by the provider. * Functions independently in the primary nurse role. Independent in performing a nursing assessment and executing the plan of care in all settings the participant maybe in. * Medication administration * Performing bladder scans, EKG, Point of Care, and glucometer testing Qualifications Education: * Graduate of an accredited school of nursing License/Certifications: * Current license as an RN in the state of Massachusetts * CPR and Alzheimer's certification, or willingness to be certified within 60 days of hire, is essential. * Access to reliable transportation to perform work throughout the PACE center's service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage. Experience: * At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population. Ambulatory care or home care experience helpful. * Ability to use an electronic medical record. Other: * Reliable Transportation Required * Pay Range Disclosure: * In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $93,000 to $94,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. This position requires permanent work authorization in the U.S. We will not provide visa sponsorship or accept candidates on OPT/CPT for this role. Brief Summary of Purpose: Seeking a motivated and detail-oriented analyst to join our team. This position is ideal for candidates who have passed at least two actuarial exams and are eager to apply their analytical skills to support key business functions such as pricing, reserving, forecasting, and risk analysis. Responsibilities Primary Job Responsibilities Assist in the development and maintenance of actuarial models for valuation, forecasting, pricing, and/or risk analysis Perform data analysis and experience studies using large datasets from internal and external sources Support the preparation of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses Collaborate with cross-functional teams including finance, claims, sales, and product development to evaluate the impact of benefit changes, provider contracts, and regulatory updates Document assumptions, methodologies, and results in compliance with ASOPs, CMS guidance, and state/federal requirements Contribute to the automation and streamlining of actuarial processes Stay current with industry trends, regulatory changes, and professional standards Qualifications Education: BS or BA in Actuarial Science, Mathematics, Statistics, Finance, Economics or related field. License/Certifications: Passage of at least two Society of Actuaries exam is required. Experience: The ideal candidate must possess: Excellent quantitative, problem-solving, and analytical skills Attention to details and ability to learn quickly Well-developed oral and written communication skills Ability to work independently and as part of a team Proficiency in Excel; experience with actuarial software (e.g. - SAS, SQL, Python, VBA) is a plus Familiarity with insurance products and regulatory environments Commitment to pursuing actuarial credentials with the Society of Actuaries and professional development Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $85,000 to $ 90,000 , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Not Ready to Apply? Join our Talent Community now!

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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: Under the direction of the Manager's, the Eligibility and Revenue Operations Representative supports Fallon Health's mission, vision and values by providing and maintaining timely and accurate enrollment and billing information. Documents pertinent information enabling tracking of group/subscriber/member and eligibility and adheres to internal and external SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage, Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health Weinberg and any future regulatory products is entered into Fallon Health's core system. Completes work accurately and timely to remain in compliance with DOI, CMS and EOHHS regulations. Appropriately escalates concerns when necessary and follows issues through to closure. Reviews problems not clearly defined by written directives or instructions with the Eligibility and Revenue Operations Coordinator, Senior Financial Support or Manager to determine course of action. The Eligibility and Revenue Operations Representative collaborates effectively with co-workers and other departments to ensure quality service to our internal and external customers. Interacts with departments such as Accounting, Sales, and Regulatory Affairs. Maintains a positive approach to issues and concerns as they arise and works to identify and recommend process improvements to his/her direct manager. Responsible for ensuring the integrity of information being entered & maintained within the core system (QNXT, TruCare, EOHHS, Trackers, etc) Must have the ability to analyze various situations and be able to make independent decisions on best practices in the interest of the members and the health plan. The Eligibility and Revenue Operations Representative will assist the Management team with projects and/or daily workload for all regulatory products. Assist Account & Provider Configuration in working updates needed in sponsor configuration. This is handled through working DI reports. Pre-requisites for success in this position include Strong verbal & written communication skills including demonstrated excellence in telephone communication skills, strong organizational skills, computer skills. Performs all functions necessary to maintain accurate subsidiary accounts receivable and ensures accuracy of premium bills. Analyze/reconcile receivables balance for Commercial and Regulatory products to identify problems with payments and/or impose the delinquency process. Study the contractual terms and conditions to ensure payments received meet the contractual requirements. Handles confidential customer information. Knowledgeable of plan policies, protocols, and procedures. Requires ability to work in a fast-paced environment with multi-disciplined staff. Consistently follows through on issue resolution. Strong multitasking abilities are essential along with taking accountability and understanding job functions can change based upon business needs. Initiates self-development via available company and industry educational opportunities The Eligibility and Revenue Operations Representative is responsible for enrollment and billing maintenance, adhering to daily, weekly and monthly schedules and administrative related tasks. Responsibilities Primary Job Responsibilities: Works proactively to ensure the enrollment and billing records are kept current and accurate. Ensures goals and turnaround standards are being met or exceeded based on corporate and departmental metrics. Responsible for maintaining up to date primary care physician assignments in core system accurately and timely. This is to be completed through review of data integrity reports, and working closely with Provider Partners, Provider Relations, Contracting and Account and Provider Configuration. Maintains professional etiquette and positively represents Fallon Health when meeting in-person with customers for eligibility and premium related inquiries. Enters and maintains data in the E&B tracker in a timely and accuarte fashion to to be utilized with the required reporting from CMS and EOHHS. Assists with core system upgrade testing Assists in creating/maintaining desk top procedures and P&P's Assists Management team on audit responses and/or site visits Participates in departmental and company-wide process improvement projects, training, upgrade testing and team meetings as assigned. Performs other duties as they are assigned to meet department performance goals and to respond to changing priorities including administrative related tasks. Works department returned mail Quality control of enrollment and billing processes for accuracy and compliance to established policies and procedures. Responsible for maintaining up to date productivity records on a daily and monthly basis for corporate and departmental dashboards. Ensure adherence to documented payment plans Qualifications Education: Education: High School diploma required; bachelor's degree preferred License/Certifications: Experience: 4 plus years' experience in an office environment, preferably in health care and/or managed care system Strong analytical and problem-solving skills Aptitude towards mathematical fundamentals Flexibility in a fast-paced environment. Excellent Organizational skills/time management Strong focus on quality & performance results Systems knowledge including but not limited to MS Excel, MS Word, MS Access. Ability to effectively communicate, both written and verbal. Builds Relationships/contributes to team performance Adhere to all DOI, State, and Federal guidelines Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 25.00 per hour which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01 Not Ready to Apply? Join our Talent Community now!

This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + Great benefits! * Full-time benefits offering! * Health Insurance offerings! * Paid Time Off! * 12 Holidays! * 401K Savings Plan! * Tuition Assistance! * Vision Care, Life Insurance and more!! + *$20/hr to start and exceeds state pay average! You can also make extra depending of the shifts you can work - read on! + Extra pay for shifts outside normal workday! * Extra $3.50/hr weekdays between 7pm and 7am Monday through Friday (shift ends Friday at 7am) * Extra $4.00/hr for weekends beginning at 7pm on Friday and ending 7am on Monday. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! * Predictable Hours! * Safe and highly vaccinated work environment including the member population you care for * Our Health Aides and staff love the familiarity and relationships establishes with our members * You will likely find more autonomy and flexibility than you have in your current role * Our model is low-volume and very member and quality care focused 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 top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region. Summary: 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 disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities * Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants' homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) * Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. * Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. * Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. * Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants' motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. * Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. * Maintains a clean and safe working and/or living environment in the PACE center and/or participants' homes. * Assists with meal and snack preparation, serving, feeding as needed, and clean-up. * Uses safe techniques in all interactions with participants at the PACE Center and in participants' homes. * Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. * Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions * Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned * Actively participates in regular team meetings for health aides at respective site * Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines * Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population, preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Pay Range Disclosure: * In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $20.00 to $24.00 per hour, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This Intake Administrator position is in the Appeal and Grievance Department and may require training in our Worcester office 5 days/week from 8 am to 5 pm up to 6 months before working a hybrid schedule. Must be able to type 25 WPM. 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, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary or purpose: Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with CMS regulations, NCQA standards, other applicable regulatory requirements and member expectations. The FH Member Appeals and Grievance Intake Administrator serves to administer the FH Appeals and Grievance process as outlined in the FH Member Handbook/Evidence of Coverage, departmental policies and procedures, and regulatory standards. The Member Appeals & Grievances Intake Administrator is responsible for triaging and assigning all incoming appeals and grievances addressed to the Member Appeals & Grievances Department. This position will also provide administrative support to the department. Responsibilities * Administer FH Standard and Expedited Appeals Processes as outlined in Member Handbook/Evidence of Coverage for all products, and in compliance with applicable NCQA standards and other state or federal regulatory requirements. Strict adherence to department turn-around time standards established in accordance with regulatory standards is required. • Act as the initial investigator and contact person for member grievances and appeals, which includes, sending the appropriate acknowledgement of the grievance/appeal, educating the member and/or member representative about the grievance/appeal, gathering all pertinent and relevant information from the member regarding the grievance/appeal.• Print, mail, and triage letters at the FH corporate office located at 10 Chestnut Street, Worcester, MA.• Identifying the need for Personal Representative Authorization form, Medical Record Release Authorization form, or Provider Payment Waiver form and requests such documentation as necessary.• Assigning case files to the department staff for case management.• Managing incoming faxes and member specific data, routing to the appropriate staff member. • Producing, maintaining, and distributing reports/calendars utilized by the team to assist in workload planning.• Processes department incoming/outgoing mail per established workflows in a timely and accurate manner.• Providing administrative/clerical support to the department which may include acquisition of medical records from providers.• Retrieving messages from email and voice mailbox, routing to the appropriate staff member.• Photocopy and compilation of appeal case file when necessary.• Completion of request for additional information from external review agency.• Responsible for additional clerical/administrative responsibilities at the discretion of the Director or Manager.• Providing administrative assistance in support of the Board of Hearings (BOH) process, including preparation of hearing packets, reviewing of materials, as well as tracking and monitoring hearing decisions.• Ensure that all grievances/appeals are processed in adherence to state and federal regulations (i.e., CMS, MassHealth, OPP), contractual obligations, NCQA guidelines and FH policy. Qualifications Education: College Degree (B.S. or B.A.) or equivalent License/Certifications: Reliable transportation required Experience: 2 years college education (or knowledge of healthcare field equal to 2 years college preparation) Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $21 - $22/hour, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P03