- State of Minnesota (St. Paul, MN)
- …Medicaid Medical Director, Health Improvement and Benefit Design, Managed Care Contracting and Rates, Medicaid Payments and Provider Services, Pharmacy ... **Working Title: Deputy Assistant Commissioner for Medicaid Coverage and Service Delivery** **Job Class: Human... Coverage and Service Delivery** **Job Class: Human Servicers Manager 5** **Agency: Human Services Dept** + **Job ID**… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting , this position is responsible for managing the payor contracting functions for the ... Ford Health. This position is responsible for leading the Managed Care Contracting team in evaluating, analyzing, and negotiating contract terms and reimbursement… more
- State of Minnesota (St. Paul, MN)
- …Commissioner for Medicaid Eligibility and Compliance** **Job Class: Human Servicers Manager 5** **Agency: Human Services Dept** + **Job ID** : 83382 + ... 02/07/2025 + **Hiring Agency/Seniority Unit** : Human Services Dept / DHS Manager + **Division/Unit** : Health Care Administration / Assistant Commissioner + **Work… more
- Providence (Irvine, CA)
- …retain the best people, we must empower them._** **Providence is calling a Senior Manager Contracting who will:** + Be responsible for leading, or participating ... for revenue primarily associated with Commercial, Medicare Advantage, and managed Medicaid products + Develop complex negotiation strategies and secure acceptable… more
- Prime Therapeutics (Columbus, OH)
- …for contract administration and ensuring process adherence in support of Prime's contracting efforts with Louisiana Medicaid PBM business. This position is ... every decision we make. **Job Posting Title** PBM Contract Representative Sr - LA Medicaid **Job Description** The Senior Contract Representative is responsible… more
- Healthfirst (NY)
- …point of contact for all plan related issues including marketing, enrollment, contracting , billing and reimbursement. + Responsible for the resolution of all issues, ... reporting on providers' clinical quality & financial performance, working with their manager and other internal departments to create strategic improvement plans. +… more
- UT Health (Houston, TX)
- Manager , Facility Contracting and Provider Enrollment Services **Location:** Houston, Texas **Hot** **Category:** Healthcare Support Services UTHealth Houston ... dates, and ensures correct rates are updated in Epic. + TMHP ( Medicaid ) Administrator: adds new users, links existing users; updates facility information. +… more
- Elevance Health (Overland Park, KS)
- …+ Identifies network access and deficiencies and develops recruitment and contracting strategies. + Coordinates and conducts provider training including developing ... is very strongly preferred. + Experience with LTSS provider contracting and credentialing is a huge plus. + You...very strong verbal and written communication skills. + Previous Medicaid or LTSS claims experience is helpful. + Strong… more
- WellSense (Boston, MA)
- …network, maintaining complex and geographically diverse contracts. Under the direction of the Manager of Hospital & Physician Contracting , the Senior Contract ... **Supervision Received:** . General supervision is received weekly from the Manager of Hospital & Physician Contracting . **Qualifications:** **Education… more
- Molina Healthcare (CA)
- …California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... with all relevant federal, state and local regulations. Responsible for contracting /re- contracting of Complex contracts with Alternative Payment Methods… more
- LA Care Health Plan (Los Angeles, CA)
- …to comply with State and Federal requirements for all product lines of business ( Medicaid , Medicare, and Commercial). The Account Manager III is responsible for ... Provider Network Account Manager III Job Category: Provider Relations Department: Provider...for all aspects of the LA Care (LAC) provider contracting and relationship management process, including drafting, reviewing, negotiating… more
- AbbVie (Mettawa, IL)
- …of pharmaceutical businesses such as the Commercial Insurance channel, Medicare and Medicaid Channels. The role is a meld of Analytics and Finance, requiring ... in this role will help to ensure AbbVie has the appropriate pricing and contracting analytics for our current products, as well as future pipeline products. Key Job… more
- CVS Health (Sacramento, CA)
- …convenient and affordable. **Position Summary** The Contract Negotiation Senior Manager negotiates, executes, conducts deep-dive review and analysis of dispute ... adequacy targets + Support health plan with expansion initiatives or other contracting activities as needed + Initiates, coordinates and own the contracting… more
- Molina Healthcare (North Charleston, SC)
- …Carolina _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... result in high quality, cost effective and marketable providers. Contract/Re- contracting with large scale entities involving custom reimbursement. Executes… more
- Elevance Health (Atlanta, GA)
- **Provider Network Manager Senior** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of ... our Elevance Health PulsePoint locations. The **Provider Network Manager Senior** will be responsible for developing the provider network through contract… more
- Trinity Health (Columbus, OH)
- …to get paid every day! **About the job:** The Provider Relations & Network Manager is responsible for a full range of provider relations and service interactions in ... MediGold's Ohio market, including: contracting and recruitment, issue resolution and escalations, strategy development...of protocols and procedures of Centers For Medicare and Medicaid Services + Proven ability to work effectively with… more
- Molina Healthcare (Long Beach, CA)
- …lead or support various Provider Services functions with an emphasis on contracting , education, outreach and resolving provider inquiries. * In conjunction with the ... Provider Network Management & Operations, develops health plan-specific provider contracting strategies, identifying specialties and geographic locations on which to… more
- Abbott (Boston, MA)
- …measure, track and analyze glucose levels. As a Senior Strategic Account Manager , responsibilities entail securing access for the entire line of ADC Products ... following customer types: Health Plans, Managed Care Organizations, Employer Groups, managed Medicaid , FFS Medicaid and Medicare plans within the market access… more
- City of New York (New York, NY)
- …Health Systems seeks to hire a Healthcare Payment and Financing Innovation Manager . This position will be responsible for conducting payment, financing and ... related to Local Law 78 and its relationship to Medicaid , Medicaid Policy an Programming, and payment...demonstrated expertise in at least one of the following: Contracting , Invoicing, payment and financing experience at local, state,… more
- Stanford Health Care (Palo Alto, CA)
- …cash posting of all hospital charges from all payors. The Senior Manager assists the Director in establishing the organizational priorities and operational ... performance of the Hospital Revenue Cycle. The PFS Senior Manager acts as a liaison between PFS operations and...Ensures compliance with policies and directives issued by Medicare, Medicaid , Third Party Payers, and others as needed. +… more