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Oracle database administrator Jobs in Worcester ma

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Oracle database administrator • worcester ma

Last updated: 9 hours ago
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Member Appeals and Grievance Intake Administrator

Member Appeals and Grievance Intake Administrator

Fallon HealthWorcester, MA, US
Full-time
Member Appeals And Grievances Intake Administrator.Fallon Health (FH) Appeals and Grievance process is an essential function to FH's compliance with CMS regulations, NCQA standards, other applicabl...Show moreLast updated: 30+ days ago
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Program Administrator

Program Administrator

UMass Chan Medical SchoolWorcester, MA, US
Full-time
Under the general direction of the Associate Director or designee, the Program Support Administrator provides high-level and diverse coordination and support for multiple programs, professional dev...Show moreLast updated: 9 hours ago
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Housing Administrator

Housing Administrator

Open Sky Community ServicesWorcester, MA, US
Full-time
Open Sky Community Services is seeking a Housing Administrator to support individuals living in subsidized housing.The Housing Administrator will serve as liaison with funders, local housing author...Show moreLast updated: 11 days ago
Security Systems Administrator

Security Systems Administrator

University of MassachusettsWorcester, MA, US
Full-time
Under the general direction of the Chief of Police or designee, the Security Systems Administrator is responsible for the implementation and support for a broad range of physical security system ma...Show moreLast updated: 10 days ago
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HR Administrator

HR Administrator

e-Careers LimitedWorcester, MA, US
Full-time
Are you looking to build a career working in an office environment?.Does a future in HR sound exciting?.If so, this opportunity could be for you!. Due to a severe skills shortage in the marketplace,...Show moreLast updated: 1 day ago
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Home Health Administrator

Home Health Administrator

Oriol Home Health IncHolden, MA, US
Full-time
Home Health Care Administrator.Bachelor's Degree required.Pay Range (depending on experience) : .The Home Care Administrator plays a crucial leadership role in the healthcare sector, particularly...Show moreLast updated: 30+ days ago
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Scale Operator / Office Administrator

Scale Operator / Office Administrator

Casella Waste Systems, IncAuburn, MA, US
Full-time
At Casella, our vital work helps bring sustainability to the planet's limited resources.As a member of our team, you can make a difference for our customers and your community.Bring us your talent ...Show moreLast updated: 7 days ago
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Assoc Academic Administrator (Orthopedics) - 40 hours, Days

Assoc Academic Administrator (Orthopedics) - 40 hours, Days

UMass Memorial HealthWorcester, MA, US
Full-time
At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities.Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the pre...Show moreLast updated: 30+ days ago
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Academic Administrator III

Academic Administrator III

University of Massachusetts Medical SchoolWorcester, MA, US
Full-time
Explore the Possibilities and Advance with Us.Under the general direction of the Department Chair or designee, the Academic Administrator III is responsible for planning and managing the administra...Show moreLast updated: 1 day ago
Oracle Database Administrator

Oracle Database Administrator

VirtualVocationsWorcester, Massachusetts, United States
Full-time
A company is looking for a Senior Oracle Database Administrator.Key Responsibilities Administer, monitor, and maintain Oracle databases (11g / 12c / 19c) Plan and execute end-to-end migration of Ora...Show moreLast updated: 30+ days ago
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Program Administrator

Program Administrator

UMass Med SchoolWorcester, MA, United States
Full-time
Under the general direction of the Associate Director or designee, the Program Support Administrator provides high-level and diverse coordination and support for multiple programs, professional dev...Show moreLast updated: 1 day ago
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Sitefinity Content Administrator

Sitefinity Content Administrator

Perfict GlobalBerlin, MA, US
Full-time
Perfict Global is a leading IT consulting services provider focused on providing innovative and successful business workforce solutions to Fortune 500 companies. Our trained and experienced professi...Show moreLast updated: 8 days ago
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Payroll Administrator

Payroll Administrator

R.H. White ConstructionAuburn, MA, US
Full-time
The Payroll Administrator will support the management of the payroll operations for our organization.This role is responsible for performing accurate and timely processing of weekly payroll, tax pa...Show moreLast updated: 30+ days ago
Office Administrator

Office Administrator

Russian School of MathShrewsbury, MA, United States
Part-time
RSM's unique approach develops critical thinking and has built excellence in math since 1997.Recently featured by NPR and the Atlantic magazine as one of the players in the "Math Revolution" and ra...Show moreLast updated: 14 days ago
Administrator

Administrator

Hudson View NetworkRutland, Massachusetts
Permanent
A beautiful, skilled nursing facility located.Responsibilities of the Administrator.Monitor and maintain compliance with federal and state regulations. Maintain written policies and procedures that ...Show moreLast updated: 30+ days ago
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Public Safety Administrator - Dispatcher

Public Safety Administrator - Dispatcher

InsideHigherEdWorcester, Massachusetts, United States
Full-time
Under the direct supervision of the Lead Public Safety Administrator or designee, the Public Safety Administrator is responsible for monitoring and controlling of security systems, including equipm...Show moreLast updated: 30+ days ago
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Clinic Administrator - Luke and Lilly Lerner Clinic

Clinic Administrator - Luke and Lilly Lerner Clinic

Tufts UniversityNorth Grafton, MA, United States
Full-time
The Luke and Lily Lerner Spay / Neuter Clinic provides students at the Cummings School of Veterinary Medicine with opportunities for both pre-clinical and clinical surgical training while serving pet...Show moreLast updated: 9 days ago
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Payroll Administrator

Payroll Administrator

King & BishopNorthborough, MA, US
Full-time
Our client is seeking a detail-oriented.HR / benefits functions for a growing organization.This role offers the opportunity to take ownership of payroll operations while gaining exposure to benefits ...Show moreLast updated: 1 day ago
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Scale Operator / Office Administrator

Scale Operator / Office Administrator

CasellaAuburn, MA, US
Full-time
Scale Operator / Office Administrator.The Scale Operator / Office Administrator provides professional clerical and administrative support to the division by providing support to managers, employees, an...Show moreLast updated: 30+ days ago
Central Massachusetts Administrator

Central Massachusetts Administrator

Vantage Care ManagementWorcester, MA
Full-time
Join Our Amazing Team!!! .We are seeking talented LNHA to join our dynamic team at.Show moreLast updated: 17 days ago
Member Appeals and Grievance Intake Administrator

Member Appeals and Grievance Intake Administrator

Fallon HealthWorcester, MA, US
30+ days ago
Job type
  • Full-time
Job description

Member Appeals And Grievances Intake Administrator

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.

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.

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)

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.