The Care Coordinator or Navigator partners with Fallon Health Care Team staff and other providers to communicate at all times what is occurring with the member and their status. The Care Coordinator or Navigator seeks to establish telephonic and face to face (depending upon product and circumstance) relationships with the member/caregiver(s) and provider partners to bette

Responsible for working with pre enrollees, participants, caregivers, staff and external regulatory staff (such as Mass Health) and NaviCare NHC pre enrollees to assure that enrollment in the Medicare and Medicaid systems is accomplished accurately and efficiently with appropriate information entered in the FCHP systems. Also, responsible to ensure recertifications are su

Our Physicians have flexibility to devote as much time as needed for the clinical and social needs of our participants and their caregivers to provide individualized quality care by a team of geriatric care professionals who work together with participants and caregivers to address each individual's specific needs. This team of professionals is an essential component of t

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

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

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

The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on care coordination, care management and improving access to and quality of care for Fallon members. NCM seeks to establish telephonic and/or face to face relationships with the member/caregiver(s) to better ensure ongoing service provision and care coordination, consistent with the mem

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

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

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

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