- The Cigna Group (Bloomfield, CT)
- This position serves as an integral member of the Provider Contracting Team and reports to the Medicare West Region Contracting Senior Manager. This role ... Compliance, Sales and Marketing and Service. + Manages strategic positioning for provider contracting , develops networks and identifies opportunities for greater… more
- The Cigna Group (Bloomfield, CT)
- The Provider Contracting Senior Advisor is a key contributor to the development of the strategic direction and is accountable for the management of value based ... equivalent relevant experience in progressively responsible leadership roles focused on managed Medicare and provider engagement. + **Experience from a large,… more
- The Cigna Group (Bloomfield, CT)
- …facing and will directly oversee relationships between the Commercial and Medicare Advantage Segment encompassing Supplemental vendor relationships including but ... NANPM Medicare & Commercial Alignment. Experience with Medicare Advantage and /or the Government Business...Master's degree preferred. + 8-10 years of experience in provider , client and customer relations, contracting or… more
- The Cigna Group (Nashville, TN)
- …Business Finance Officer (BFO), supporting the Midwest and MidAmerica markets of our Medicare Advantage business. We are seeking a creative and strategic finance ... decisions for market and matrix partners in Medical Services, Contracting , Sales and Network Operations. + Responsible for analysis...able to lead and delegate responsibilities as needed + Medicare Advantage experience and general knowledge of… more
- Cedars-Sinai (Los Angeles, CA)
- …complex MH services, including maintaining the network of providers for the CSMN Medicare Advantage plan(s). + Assists Contracting with identification, ... professionals (generally LCSWs) within our transformed primary care practices who provide evidence-based therapy to patients receiving mental health care under their… more
- The Cigna Group (Atlanta, GA)
- …All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: **Growing ... Clinical Operations, Stars & Risk Adjustment, Finance , Cross-Segment Contracting , Provider Relations, and Network Development &..._###@cigna.com_ _for an update on your application or to provide your resume as you will not receive a… more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... opportunity seizing solutions to drive performance for value-based contracts for Medicare Advantage , Managed Medicaid and Commercial arrangements. * Support… more
- Mount Sinai Health System (New York, NY)
- …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year...and report the financial performance for all Commercial and Medicare Contracts with Mount Sinai. The Senior Contracting… more
- Aspen Dental (Springfield, IL)
- … billing and reimbursement, administration, systems, practices and principles, (ie Medicaid, Medicare , Medicare Advantage , and Commercial.) + Excellent ... an exciting opportunity to join our team as Manager, Contracting . The Manager, Contracting plays a vital...with operational and revenue cycle teams at the various provider entities. + Other duties as assigned. **Experience** +… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …Services (CMS), Office of Financial Management (OFM), Div. of Medicare Advantage and Drug Error Rate. As a Contracting Officer Representative, GS-1101-13, ... evaluate possible courses of action for resolving them. Serve as a Contracting Officer Representative (COR) Level III on multi-million-dollar program learning or… more
- Medical Mutual of Ohio (OH)
- …including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. **Responsibilities** ** Provider Analyst II** Provides ... degree preferred.** **.** **3 years of health care consulting, provider contracting , or provider reimbursement...as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide… more
- Medical Mutual of Ohio (OH)
- …stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans.** **Responsibilities** ** Provider Reimbursement Analyst II** ... Analyst** Under minimal supervision, acts as thought leader in Provider Contracting . Conceptualizes new approaches to reimbursements...as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans provide peace of mind to more ... self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and...issues, analyzing, and assessing risks. Draft and review key provider contracting documents. Present clear recommendations and… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Medical Mutual' ... the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million...Network Informatics team which has numerous projects centered around provider contract management and value-based contracting . +… more
- Elevance Health (West Des Moines, IA)
- …Iowa, positively impacting the affordability of respective Medicaid and Medicare Advantage health plan products. + Develops new provider networks that ... Provider Solutions will be responsible for strategic leadership over all provider engagement and contracting activity throughout Iowa, including cost of care… more
- The Cigna Group (Pittsburgh, PA)
- …for managing contracting and network management activity supporting Commercial, Medicare Advantage , and other products/initiatives (ie Exchange products) as ... This position serves as an integral member of the Provider Contracting Team and reports to the..._###@cigna.com_ _for an update on your application or to provide your resume as you will not receive a… more
- Trinity Health (Columbus, OH)
- …Day Shift **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... relations work within the area or market (including contracting , recruitment, provider retention and strategy development)...Working knowledge of protocols and procedures of Centers For Medicare and Medicaid . Services . Proven ability to… more
- Molina Healthcare (MI)
- …It is an external-facing, field-based position requiring an in-depth knowledge of provider relations and contracting subject matter expertise to successfully ... complex provider issues that may cross departmental lines including Contracting , Finance, Quality, Operations, and involve Senior Leadership. * Responsible for … more
- Molina Healthcare (New York, NY)
- …with (Medicaid/ Medicare )** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and ... It is an external-facing, field-based position requiring an in-depth knowledge of provider relations and contracting subject matter expertise to successfully… more
- UCLA Health (Los Angeles, CA)
- …+ A Bachelor's degree or equivalent experience + 3-4 years of experience working in a Medicare Advantage health plan or Managed Care team - Claims, Provider ... Description The Provider Data Management Senior Analyst will be responsible...for processing, maintaining, and updating all aspects of the provider information database across all health plan products. You… more