- Elevance Health (Houston, TX)
- …** The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, ... **JR177058 Provider Network Manager...the network . + Ability to identify and address network gaps effectively. + Experience with contract and… more
- Elevance Health (Walnut Creek, CA)
- …** The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, ... Provider Network Manager...Primary focus of this role is contracting and negotiating contract terms. + Typically works with less-complex to complex… more
- Commonwealth Care Alliance (Boston, MA)
- …health (SDOH) measures. The Program Manager will work collaboratively with our provider network and Quality teams to identify quality metrics that align ... Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation...Analyze CAHPS results to identify trends and collaborate with Provider Network , Clinical and Quality teams to… more
- AmeriHealth Caritas (Charleston, SC)
- **About the job:** The Manager of Provider Network Management manages the Network Management department's and staff's day-to-day activities. Responsible ... education, and communication. This position is also responsible for all provider network recruiting and contracting management activities by ensuring… more
- AmeriHealth Caritas (Washington, DC)
- …satisfaction, education, and communication. This position is also responsible for all provider network recruiting and contracting management activities as it ... provider contracts. + Responsible for implementation of electronic strategies for provider network to include increasing electronic claims submission and… more
- Elevance Health (Atlanta, GA)
- …within a commuting distance from an office. **Position Overview:** Develops the provider network through contract negotiations, relationship development, and ... communication link between professional providers and the company + Ensure that network composition includes an appropriate distribution of provider specialties… more
- Elevance Health (Lake Mary, FL)
- ** Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Provider Contract Cost of Care Analyst Senior**...improving the quality of care, and increasing member and provider network satisfaction. + Typically works with… more
- Elevance Health (Norfolk, VA)
- ** Provider Contract /Cost of Care Consultant** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and ... for employment, unless an accommodation is granted as required by law. The ** Provider Contract /Cost of Care Consultant** provides analytical support to the Cost… more
- Molina Healthcare (Austin, TX)
- …that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract Specialists on negotiation of individual ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...ongoing after contract . * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider… more
- The Cigna Group (Richmond, VA)
- …Ancillaries, and Physician groups? If so, read on to learn more! As a Provider Contracting Negotiator Manager at Cigna Healthcare, you'll be an integral member ... risk arrangements. + Contribute to the development of alternative network initiatives. Support and provide direction to...and project the financial impact of larger or complex provider contracts and alternate contract terms. +… more
- Molina Healthcare (Jackson, MI)
- …and experience. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : * 4-6 years provider contract network relations and management experience in ... and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development,… more
- Elevance Health (Grand Prairie, TX)
- …impact on the quality-of-service delivery. + Research issues that may impact future provider contract negotiations or jeopardize network retention. **Minimum ... **JR177060 Provider Relationship Account Manager ** Responsible for...and resource expert regarding provider issues impacting provider satisfaction and network retention; researches, analyzes,… more
- Molina Healthcare (MA)
- …must reside in Massachusetts or surrounding state **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, ... staff are the primary point of contact between Molina Healthcare and contracted provider network . In partnership with Director, manages and coordinates the … more
- Point32Health (Canton, MA)
- …to understand performance, financial or otherwise, of the allied provider network . Work closely with the contract management staff and legal department ... Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for...we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Manager of Allied Health Contracting oversees a team of… more
- Molina Healthcare (Bellevue, NE)
- …region. + Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on ... effective and marketable providers. **KNOWLEDGE/SKILLS/ABILITIES** + In conjunction with Director/ Manager Provider Contracts, negotiates high priority physician… more
- Centene Corporation (Tallahassee, FL)
- …Purpose:** Develop strategic partnerships between the health plan and the contracted provider networks serving our communities. Engage with providers to align on ... network performance opportunities and solutions, and consultative account management...and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. Participate in… more
- Prime Therapeutics (Santa Fe, NM)
- …purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Provider Relations Manager - Remote **Job Description** The Manager ... pharmacy contracting, compliance and issue resolution with pharmacies to ensure network integrity, service quality, and cost-effectiveness. The role is also… more
- Centene Corporation (Atlanta, GA)
- …Purpose:** Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery ... of care to our members. Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for… more
- CareFirst (Baltimore, MD)
- …for planning and managing day to day activities regarding network development. Responsibilities include provider recruiting/contracting for commercial ... access. + Maintain standard professional, ancillary, and institutional (non-hospital) provider agreements, update contract language and draft amendments.… more
- Centene Corporation (Nashville, TN)
- … reporting and directories as well as claims payment resolution as it relates to provider set up. Provide support to external provider representatives to ... ancillary providers within assigned area. + Act as account manager for assigned groups acting as gatekeeper for interactions...liaison between assigned providers and the health plan. + Provide issue resolution support for most complex provider… more
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