- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... focus on value-based arrangements and network-wide engagement strategies. The program manager is responsible for managing and implementing key population health and… more
- Commonwealth Care Alliance (Boston, MA)
- …partners closely with provider engagement, delegation partnerships, provider services, contracting , quality, compliance, medical management, and analytics teams to ... Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational objectives, regulatory… more
- Pairtu (San Francisco, CA)
- …looking for a senior, hands-on operator who can work across credentialing, payer contracting , provider onboarding, and day-to-day ops while keeping a sharp eye on ... need structure and predictability or 'need to be a manager ' this isn't for you. The upside? You'll level...from an anxious senior patient to a health plan contracting lead. **Bonus points if you've:** - Worked with… more
- Commonwealth Care Alliance (Boston, MA)
- …, Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing activities, including onboarding, orientation ... strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital role in helping CCA achieve its mission and… more
- CVS Health (Trenton, NJ)
- …we do it all with heart, each and every day. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our Network ... responsibilities as provided within the State Medicaid contractual requirements as outlined below: + Accountable for...provider agreements. + In charge of complete value based contracting cycle from planning, creating documents, and negotiation to… more
- CVS Health (Lansing, MI)
- …**Position Summary** In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high level review and rate ... and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the development and implementation… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Managed Care Contracting and Rates (MCCR) Director** **Job Class: Human Services Manager 4** **Agency: Human Services Dept** + **Job ID** : ... : 12/23/2025 + **Hiring Agency/Seniority Unit** : Human Services Dept / DHS Manager + **Division/Unit** : Health Care Administration / Managed Care Contracting … more
- CVS Health (Columbus, OH)
- …impact by:** . Supporting the process for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners. . Developing ... each and every day. **Position Summary** Aetna is recruiting for a Senior Manager , Value Based Contractor who will partner with business development and network… more
- Ascendis Pharma (Princeton, NJ)
- …develop their skills. Position Summary: We are seeking a highly motivated Senior Manager to support our Contracting Operations function within the Market Access ... the day-to-day management of contract operations activities across pharmaceutical pricing, contracting , and rebate agreements with payers, PBMs, GPOs, and other… more
- CVS Health (Annapolis, MD)
- …financial issues and competitor strategies, complex contracting options, financial/ contracting arrangements and regulatory requirements. + Medicaid Network ... adhere to guidelines and requirements. + Initiates moderate and/or complex contracting activities, including the collection of all required contract and… more
- Albany Medical Center (Albany, NY)
- …and employee related activities, as applicable, under the System Payer Contracting Unit. The Director prepares annual budget target recommendations in conjunction ... Finance and other stakeholders. The Director possesses deep marketplace and payer contracting expertise to meet the high level, multifaceted competencies needed for… more
- IQVIA (New Providence, NJ)
- **Job Overview** During project assignments, works closely with Principal/Engagement Manager , serving as a key contributor to client engagements, with a focus on ... (SME) within one or more specific functional or technical workstreams (eg, Medicaid , Master Data Management, Chargebacks, Government Pricing, Testing, Managed Care … more
- Mount Sinai Health System (New York, NY)
- …within Mount Sinai. The team includes 400+ employees with clinical, contracting , finance, IT, analytics, operations, and product development expertise. MSHP is ... the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation,...to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's… more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... LinkedIn. **Brief summary of purpose:** Under the direction of the Manager 's, the Eligibility and Revenue Operations Representative supports Fallon Health's mission,… more
- AmeriHealth Caritas (Washington, DC)
- …This position is also responsible for all provider network recruiting and contracting management activities as it relates to the Health DC Plan. Ensures ... to reflect changes. Ensures department achieves annual goals and objectives. ** Contracting ** + Responsible for hospital and physician network development and… 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
- OhioHealth (Marion, OH)
- …Summary:** The primary focus of this role is to lead the contracting strategy, by developing, implementing, communicating, managing and monitoring the needs of ... the physician contracting program. This role is a subject matter expert,...Inspector General, The Joint Commission, Center for Medicare & Medicaid Services, Internal Revenue Service, etc. This position will… more
- Point32Health (Canton, MA)
- …Manager will collaborate with key internal stakeholders (Clinical, Contracting , Provider Partnerships, Actuarial, Procurement and Compliance) to refine ... complete and accurate capture of risk adjustment data. To be successful, the Manager will need to rely on strong analytic, consultative and communication skills to… more
- Abbott (Livermore, CA)
- …on with their lives. This position leads payor relations (including payor contracting ) and regulatory affairs, which are foundational functions to driving ongoing ... payor contract negotiation, payor contract implementation, payor contract monitoring, Medicare/ Medicaid enrollment, state licensing, and Joint Commission accreditation +… more
- Molina Healthcare (West Valley City, UT)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to ... result in high quality, cost effective and marketable providers. Contract/Re- contracting with large scale entities involving custom reimbursement. Executes… more
