- Molina Healthcare (Green Bay, WI)
- …on the financial impact. Work independently to support and validate Provider Network contracting and unit cost management activities through financial and ... Required Experience 5+ years of analytics experience in financial analysis, healthcare pricing, network management , healthcare economics or related… more
- Commonwealth Care Alliance (Boston, MA)
- …Skills, Abilities & Language (nice to have):** + Familiarity with provider network management systems and healthcare data standards. + Experience with ... trends to the committee + Develop and manage annual provider communications schedule + Provide guidance and...5+ years of experience in provider relations, healthcare communications, or network management … more
- Commonwealth Care Alliance (Boston, MA)
- …have): - 8-10 years of progressively responsible experience in provider relations, network management , or healthcare operations within a managed care ... quality, compliance, medical management , and analytics teams to advance provider network operations, education, and performance improvement. The Provider… more
- Commonwealth Care Alliance (Boston, MA)
- …Experience:** + 5-7 years of experience in healthcare quality improvement, provider network performance and management , population health, or related ... of health (SDOH) measures. The Program Manager will work collaboratively with our provider network and Quality teams to identify quality metrics that align… more
- Molina Healthcare (Sterling Heights, MI)
- …of education and experience. PREFERRED EXPERIENCE : 5-7 years of Program and/or Project management experience. Provider Network and SAI Excel and PowerPoint ... matter experts, delivering products through the design process to completion within Provider Network department. Help facilitate corporate markets with obtaining… more
- Molina Healthcare (Omaha, NE)
- …& ABILITIES : 4-6 years provider network relations and management experience in a managed healthcare setting. Working experience servicing complex ... staff are the primary point of contact between Molina Healthcare and contracted provider network ....provider network . They are responsible for network management including provider education,… more
- The Cigna Group (Cleveland, OH)
- …be needed to work 3 days per week in the office. Assistant Vice President, Provider Network Management , Cleveland and Northern OH (inclusive of Toledo, ... This position serves as an integral member of the Provider Contracting Team and reports to the Vice President,... Contracting Team and reports to the Vice President, Network Management , Liberty Valley. This role is… more
- Molina Healthcare (Cleveland, OH)
- JOB DESCRIPTION Job Summary Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network ... staff are the primary point of contact between Molina Healthcare and contracted provider network .... network . They are responsible for the provider training, network management and… more
- Molina Healthcare (Meridian, ID)
- …who have not responded to Contracts and/or Applications sent as directed by management . Formats and distributes Provider network resources (eg electronic ... Job Description Job Summary Molina Health Plan Provider Network Contracting jobs are responsible...system requirements of customers as it pertains to contracting, network management and credentialing. Job Duties This… more
- Molina Healthcare (Kenosha, WI)
- …models. Seeks input on new reimbursement models from Corporate Network Management and legal. Educates internal customers on provider contracts. Participates ... region. Maintains contractual relationships with significant/highly visible providers. Advises Network Provider Contract Coordinators and Specialists on… more
- Molina Healthcare (Scottsdale, AZ)
- Job Summary Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial and ... requirements of customers as it pertains to contracting and network management . Job Duties This role supports...by developing and producing as required to engage with provider and facilitate VBC performance. Supports VBC network… more
- Commonwealth Care Alliance (Boston, MA)
- …Care) populations preferred. - Experience in healthcare program management , provider relations, or network management - Knowledge of Massachusetts BH ... CCA's behavioral health priorities, programs, and initiatives to the provider network . - Promote provider ...eligible populations - Experience in behavioral health clinical practice, provider relations, or healthcare management … more
- Premera Blue Cross (Mountlake Terrace, WA)
- …through our Healthsource blog: https://healthsource.premera.com/ . **_About the role of Senior Provider Network Executive_** The **Sr. Provider Network ... highly visible role, the **PNE IV** is responsible for the negotiation and management of Premera's most complex and critical provider relationships across the… more
- Elevance Health (Morristown, NJ)
- …for autism and depression, and insightful analytics to improve the delivery of care. Provider Network Manager - New Jersey * This is an Individual Contributor ... granted as required by law. Work Shift: Monday - Friday, 40 hours a week The Provider Network Manager develops the provider network through contract… more
- CVS Health (Frankfort, KY)
- …provider data operations, including compliance. Three or more years of experience in network management , contracting, or related healthcare network ... functions. One or more years of hands-on experience with provider data management platforms. Education Bachelor's degree preferred/specialized training/relevant… more
- Seattle Children's (Seattle, WA)
- …Seattle Children's Safe Child and Adolescent Network . (http://www.seattlechildrens.org/ healthcare -professionals/refer/scan/) **Key Responsibilities:** Perform ... We are seeking a dedicated **Advanced Practice Provider (Nurse Practitioner or Physician Assistant)** to join...team-based clinical practice and consultation in the evaluation and management of pediatric patients referred for possible child abuse… more
- The Cigna Group (New York, NY)
- …strategic direction and management of the day to day contracting and network management activities for a local given territory. DUTIES AND RESPONSIBILITIES ... TO COMMUTE LOCALLY TO THE OFFICE AND PROVIDERS The Provider Contracting Advisor serves as an integral member of...loading and submissions and interface with matrix partners for network implementation and maintenance. May provide guidance… more
- Molina Healthcare (Salt Lake City, UT)
- …system requirements of customers as it pertains to contracting (benefit and provider ), network management , credentialing, prior authorizations, fee ... hours will be 7am-3:30pm PST M-F Job Summary Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal,… more
- Datavant (Denver, CO)
- …will have a deep understanding of value-based care, risk adjustment, and the healthcare provider ecosystem (risk-bearing providers, ACOs, IPAs, etc). They will ... and insights to influence product roadmap and go-to-market approaches. Relationship Management Establish and maintain executive-level relationships with provider … more
- Humana (Metairie, LA)
- …accomplished healthcare leader for the position of Regional Vice President (RVP) Provider Contracting. The RVP will provide executive leadership to the ... the compensation arrangements between health plans and providers, including plan funding, risk management and provider reimbursement. Use your skills to make an… more
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