- Centene Corporation (Raleigh, NC)
- …reporting needs and provide training and support on network performance applications and reporting tools + Lead provider profiling and network ... to support a complete business need around contracting analytics and modeling applications. Provide analytic support for network performance , unit cost… more
- Leidos (Bethesda, MD)
- …in Montgomery County, MD.The Network Security Manager (SM) leads a network security and performance management team supporting a large Agency enterprise ... Leidos Dig Mod Health IT division is seeking a Network Security Manager on a large ...+ Prioritize, assign, and oversee completion of security and network performance engineering staff tasks. + Ensure… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III...standards, provider contracts, and provider performance and needs. The Account Manager III leverages ... net required to achieve that purpose. Job Summary The Provider Network Account Manager III...understanding of LACs reports and metrics to evaluate the performance of assigned providers and/or provider organizations,… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager II...standards, provider contracts, and provider performance and needs. The Account Manager II leverages ... net required to achieve that purpose. Job Summary The Provider Network Account Manager II...understanding of LACs reports and metrics to evaluate the performance of assigned providers and/or provider organizations,… more
- Trinity Health (Columbus, OH)
- …of a geographic area or market of Provider Relations Managers. The Market Manager Provider Relations and Network Development will maintain a portfolio of ... own in Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** Market Manager - Provider Relations and Network Development is responsible… more
- Point32Health (FL)
- … & Provider Analytics and other members of the Network & Provider Analytics team, the Senior Manager will lead the analytic support of contract ... will also provide support for regulatory requests around access and network adequacy. **Key** **Responsibilities/Duties** **- what you will be doing** + Manages… more
- Trinity Health (Boise, ID)
- …Responsible for issuing new network Participation Agreements for all network provider types. Assists Contract Specialist in verifying contract terms, ... the work necessary for resolution of questions regarding claims, fee schedules, network contracting, provider credentials verification, payer enrollment, and … more
- CVS Health (Richmond, VA)
- …Promote collaboration with internal partners. . Evaluate, formulate, and implement the provider network strategic plans to achieve contracting targets and manage ... in your next role? Join Aetna/CVS Health, a Fortune six company, as the Network Management Senior Manager . In this individual contributor role, you will… more
- CVS Health (Hartford, CT)
- …Sr. Manager role who will serve as a Delivery Lead for the Provider Network Platform Solutions organization. This strategic role will be responsible for ... project value delivery + Conduct regular progress reviews and provide transparent reporting on project performance , value...health insurance industry, preferably in a role related to network , provider , or payer operations + Deep… more
- Elevance Health (Wilmington, DE)
- ** Provider Network Management Director Sr** **Location:** This position will work a hybrid model (remote and office). Ideal candidates must live within 50 miles ... of a PulsePoint location. The ** Provider Network Management Director Sr** is responsible...* Shared savings/incentive payouts based on cost and quality performance and budget expenses. **Minimum Requirements:** Requires a BA/BS… more
- The Cigna Group (Bloomfield, CT)
- **OVERVIEW** The Senior Manager of Medicare Advantage Provider Directory Vendor and Regulatory Operations is responsible for overseeing the regulatory compliance ... (eg, state and federal) of the provider directory, network adequacy, and all related...regulatory requirements. **Vendor and Business Operations Support:** + Oversee performance of all third-party vendors that support provider… more
- Molina Healthcare (NV)
- …and must live in Nevada _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy ... and development with respect to adequacy, financial performance and operational performance , in alignment with...negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of… more
- Magellan Health Services (Honolulu, HI)
- …zoom or Teams. + Devises and implements strategies to drive provider performance and enhance quality in alignment with network , clinical and quality goals. ... Collaborates with internal departments to align and deliver on network goals. Overall goal is to increase provider...goal is to increase provider satisfaction, drive provider quality and performance , and enhance the… more
- Molina Healthcare (Michigan Center, MI)
- …and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract Specialists on negotiation of individual provider … more
- Elevance Health (FL)
- …and helping to improve the value delivered to Carelon BH members. Drives BH provider performance improvement year over year through education and data. This role ... The **Behavioral Health Provider Quality Manager ** is responsible for...performance . Implements strategies that meet clinical, quality, and network improvement goals through positive working relationships with providers,… more
- The Cigna Group (Sunrise, FL)
- …and/or physician leadership including creating and delivering presentations. + Collaborating with Provider Performance Senior Manager / Manager on ... **Role Summary** The Provider Performance Enablement Lead Analyst is...that assists in the growth and development of the provider network . The External Representative is the… more
- Molina Healthcare (MS)
- …and must live in Mississippi _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... desire goals and reduce minimize the company's financial exposure. * Advises Network Provider Contract Specialists on negotiation of individual provider… more
- The Cigna Group (Denver, CO)
- …and/or physician leadership including creating and delivering presentations. + Collaborating with Provider Performance Senior Manager / Manager on ... network and membership growth. **Delivering** **our** **Services** The Provider Performance External Representative is accountable for the exceptional… more
- Avera (Sioux Falls, SD)
- …role will assist provider training, orientation, and coaching for performance improvement within the network . **Education and/or Experience** + Bachelor's ... providers, the organization and its customers. Responsibilities include driving AHP's provider network expansion efforts, performing detailed market analysis and… more
- The Cigna Group (Seattle, WA)
- …and/or physician leadership including creating and delivering presentations. + Collaborating with Provider Performance Senior Manager / Manager on ... **Role Summary:** The Provider Performance Lead Analyst is a...that assists in the growth and development of the provider network . The Lead Analyst is the… more