• Commonwealth Care Alliance (Boston, MA)
    …provider network operations, education, and performance improvement. The Provider Relations Director reports to the Sr Director of Delegation Partnerships and ... network performance against internal and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. -… more
    DirectEmployers Association (10/18/25)
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  • Commonwealth Care Alliance (Boston, MA)
    …to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing activities, including ... By fostering strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital role in helping CCA… more
    DirectEmployers Association (10/17/25)
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  • Commonwealth Care Alliance (Boston, MA)
    …One Care) populations preferred. - Experience in healthcare program management, provider relations , or network management - Knowledge of Massachusetts BH ... Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral… more
    DirectEmployers Association (10/18/25)
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  • Commonwealth Care Alliance (Boston, MA)
    …job. **Required Experience (must have):** + 5+ years of experience in provider relations , healthcare communications, or network management within a health plan ... 011230 CA-Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and nurturing… more
    DirectEmployers Association (10/17/25)
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  • Commonwealth Care Alliance (Boston, MA)
    011150 CCA- Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based ... One Care) populations preferred. + Experience in healthcare program management, provider relations , or network management + Knowledge of Massachusetts LTSS… more
    DirectEmployers Association (10/17/25)
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  • Commonwealth Care Alliance (Boston, MA)
    …preferred. - 1+ years of experience in LTSS, social work, provider relations , healthcare communications, project management, or network management within a ... interest and demonstrated capabilities. The position will report to the LTSS Program Manager . Reporting to the Manager , LTSS Program, this position supports the… more
    DirectEmployers Association (10/17/25)
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  • Network Development and Contracting (Value…

    CVS Health (Trenton, NJ)
    …And we do it all with heart, each and every day. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our ... Managed Care Network Value Based Contacting experience with 2-3 years Medicaid Network experience + Must have Microsoft Office experience with intermediate… more
    CVS Health (11/20/25)
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  • Manager , Network Relations

    CVS Health (Oklahoma City, OK)
    …time. + **Must reside in Oklahoma** **Preferred Qualifications** + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, ... by assisting with or responding to complex issues regarding Medicaid policies and procedures, plan design, contract language, service,...Provider Appeals & Disputes, and Network Performance Standards. + Experience in Medical Terminology, CPT,… more
    CVS Health (12/12/25)
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  • Provider Relations Manager HP

    Molina Healthcare (Lincoln, NE)
    …experience. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : * 4-6 years provider network relations and management experience in a managed healthcare ... the state of Nebraska **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for...in provider services and/or operations in a Medicare and Medicaid managed healthcare setting, ideally with different provider types… more
    Molina Healthcare (12/11/25)
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  • Sr. Manager , Payor Relations

    Abbott (Livermore, CA)
    …health and get on with their lives. This position leads payor relations (including payor contracting) and regulatory affairs, which are foundational functions to ... payor contract negotiation, payor contract implementation, payor contract monitoring, Medicare/ Medicaid enrollment, state licensing, and Joint Commission accreditation +… more
    Abbott (09/20/25)
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  • Director, Provider Relations

    Commonwealth Care Alliance (Boston, MA)
    …provider network operations, education, and performance improvement. The Provider Relations Director reports to the Sr Director of Delegation Partnerships and ... network performance against internal and regulatory benchmarks. * Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. *… more
    Commonwealth Care Alliance (10/18/25)
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  • BH Provider Engagement Program Manager

    Commonwealth Care Alliance (Boston, MA)
    …One Care) populations preferred. * Experience in healthcare program management, provider relations , or network management * Knowledge of Massachusetts BH ... Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral… more
    Commonwealth Care Alliance (10/18/25)
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  • Provider Contracting Senior Manager

    CVS Health (Columbus, OH)
    …each and every day. **Position Summary** Aetna is recruiting for a Senior Manager , Value Based Contractor who will partner with business development and network ... Specialty Partnership team. You will work collaboratively across the Network and Clinical organizations to ensure speed to market...with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. **You will make an impact by:**… more
    CVS Health (11/30/25)
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  • Manager II, Facilities Operations…

    The County of Los Angeles (Los Angeles, CA)
    MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4762503) Apply  MANAGER ... 23 health centers and four hospitals - and expanded network of community partner clinics - DHS annually provides...and administrative space. Acts as first assistant to a Manager IV, Facilities Operations and Crafts. Essential Job Functions… more
    The County of Los Angeles (10/02/25)
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  • 340B Pharmacy Manager -Pharmacist

    Bassett Healthcare (Cooperstown, NY)
    …340B Drug Pricing Program for all qualified entities throughout the Bassett Health Network . The 340B Manager serves as the primary institutional compliance ... the best quality of life possible. What you'll do Reporting to the Chief Pharmacy Officer, the 340B Manager is responsible for compliance and administration of the… more
    Bassett Healthcare (11/03/25)
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  • CISC Member, Caregiver and Stakeholder Engagement…

    Magellan Health Services (Albuquerque, NM)
    …Engagement Manager Grade 23 Work Experience - Required Community Relations /Outreach Work Experience - Preferred Education - Required Associate Education - ... Collaborates with multiple departments, including peers, business development, marketing, network contracting, and provider liaison teams. + Participates as a… more
    Magellan Health Services (09/18/25)
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  • Regional Manager , Value-Based Programs…

    Molina Healthcare (WA)
    **JOB DESCRIPTION** **Job Summary** The Regional Manager Value Based Programs plays a critical role in the development and implementation of value-based programs and ... and LOBs. **KNOWLEDGE/SKILLS/ABILITIES** + Works directly with assigned market network leaders to identify providers for value-based contracting, support local… more
    Molina Healthcare (11/09/25)
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  • Sr Manager Clinical UM Operations

    Healthfirst (NY)
    …performance Partner with Clinical Operations, Quality, Compliance, and Provider Relations to ensure alignment and effective communication across departments Utilize ... managing in a virtual environment Understanding of health plans such as Medicare, Medicaid and//or Managed Long-Term Care Plan (MLTCP) Experience working as a case … more
    Healthfirst (11/27/25)
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  • Area Manager II, Med/Surg Specialties

    Sutter Health (Sacramento, CA)
    …Medical Group and Sutter North Medical Group and a clinically integrated network (Sutter Physicians Alliance, also known as SPA), which includes Sutter Independent ... is required, including but not limited to Medicare, MediCal, Medicaid , Knox Keene Act and the Starke II Statute....II Statute. + A background and ability to form relations with physicians and medical directors as well as… more
    Sutter Health (12/05/25)
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  • Provider Engagement Professional

    Humana (Oklahoma City, OK)
    network providers in Humana's Healthy Horizons in Oklahoma's Medicaid Plan, including provider onboarding, training, education, responding to provider inquiries, ... determination of the appropriate courses of action. The Provider Relations Representative is responsible for day-to-day front line relationship management… more
    Humana (12/07/25)
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