- CVS Health (Trenton, NJ)
- …Managed Care Network Value Based Contacting experience with 2-3 years Medicaid Network experience + Must have Microsoft Office experience with intermediate ... make health care more personal, convenient and affordable. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our… more
- CVS Health (Tallahassee, FL)
- …National VBC Business Development team. You will work collaboratively across the Network and Medicaid organization to ensure speed to market and to support ... processes and interdependences are identified and addressed. + Provides network development /expansion, provider relationships, and refinement activities in… more
- CVS Health (Raleigh, NC)
- …and quality. + Health Plan/Payer or Provider Systems experience **Preferred Qualifications** + Medicaid regulatory experience + Medicaid contracting & setup ... care more personal, convenient and affordable. **Position Summary** The Lead Director, Network Management - Medicaid /North Carolina is accountable for designing… more
- CVS Health (New York, NY)
- …and quality. + Health Plan/Payer or Provider Systems experience **Preferred Qualifications** + Medicaid regulatory experience + Medicaid contracting & setup ... health care more personal, convenient and affordable. **Position Summary** The NJ Medicaid Lead Director, Network Management is accountable for designing… more
- CVS Health (Oklahoma City, OK)
- …is an individual contributor role._ **Required Qualifications** * 7-10 years of network contracting /management experience. * Ability to travel as needed (up ... to leadership. * Engage with providers and quickly move the providers though contracting processes in order to ensure meeting network adequacy requirements.… more
- CVS Health (Princeton, NJ)
- …must reside in New Jersey. The primary functions of the BH Senior Manager of Network Relations are: + Involvement in the development and maintenance of a ... + Provide provider education and develop and deliver provider training + Ensure network adequacy and appointment access, including development of network … more
- CVS Health (Columbus, OH)
- …of provider networks as they pertain to Medicaid products ( contracting , adequacy, value-based payment models) + Previous Network experience **Education** ... position will oversee and manage complex projects in support of Government Programs Network team's process, operations, and strategy as it relates to alignment with… more
- Humana (Springfield, IL)
- …make an impact** **Required Qualifications** + 8 or more years of progressive network management experience including hospital contracting and network ... our caring community and help us put health first** The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider… more
- Humana (Madison, WI)
- …**Required Qualifications** + Bachelor's degree + 5 or more years of progressive network management experience including hospital contracting and network ... eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities **HireVue** As… more
- Humana (Olympia, WA)
- …make an impact** **Required Qualifications** + 6 or more years of progressive network management experience including hospital contracting and network ... + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Interviewing… more
- Bon Secours Mercy Health (Richmond, VA)
- …on the standardization of processes, reporting and approaches to payer contracting , payer relationships, network participation and other strategic project ... are recognized for clinical and operational excellence. **Director, Payer Contracting ** **| Remote** This position is responsible for developing, managing,… more
- CVS Health (Hartford, CT)
- …is responsible for ensuring the variations that currently exist across multiple Medicaid Health plans specific to provider contracting , credentialing, provider ... control points to drive alignment and transparency with the Network Operations Team and the Medicaid Health...skills. You'll make an impact by: + Leading the development and execution of process mapping, workflows, audit, and… more
- CVS Health (Dallas, TX)
- …proficient in Word, Excel, and Microsoft Office. **Preferred Qualifications** + Medicaid contracting experience. + Strong critical thinking, problem resolution, ... helping you achieve your career goals._** **In this Texas Medicaid individual contributor role the contract negotiator:** + Negotiates...as needed. May recruit providers as needed to ensure network adequacy and achievement of network expansion… more
- Prime Therapeutics (Columbus, OH)
- …we make. **Job Posting Title** Contract Manager Vendor Performance - LA Medicaid - Remote **Job Description Summary** Responsible for the implementation and support ... with all areas of the Prime Therapeutics organization to coordinate network management and network administration responsibilities and facilitates resolution… more
- Prime Therapeutics (Columbus, OH)
- …we make. **Job Posting Title** Contract Manager - Vendor Performance NC Medicaid - Remote **Job Description Summary** Responsible for the implementation and support ... with all areas of the Prime Therapeutics organization to coordinate network management and network administration responsibilities and facilitates resolution… more
- CVS Health (Richmond, VA)
- …during the credentialing or data management processes. - Responds to network or provider/producer inquiries, including contracting and credentialing policy, ... - Maintains high production and quality factors. - Participates in development of credentialing processes and workflows. - Identifies improvement opportunities and… more
- Trinity Health (Columbus, OH)
- …with focus on system wide contracting opportunites. . Develop and implement a network development plan for multiple regions. . Work with senior leadership to ... the provider network staff, which may include network development , contracting , credentialing, provider...of protocols and procedures of Centers For Medicare and Medicaid . Services . Proven ability to work effectively… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III Job Category: Provider Relations Department: Provider Network Management Location: Los Angeles, CA, US, 90017 Position Type: ... to support the safety net required to achieve that purpose. Job Summary The Provider Network Account Manager III is responsible for all aspects of the LA Care (LAC)… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager II Job Category: Provider Relations Department: Provider Network Management Location: Los Angeles, CA, US, 90017 Position Type: ... to support the safety net required to achieve that purpose. Job Summary The Provider Network Account Manager II is responsible for all aspects of the LA Care (LAC)… more
- Elevance Health (Richmond, VA)
- …or provider side. + Knowledge of Commercial and Medicare, and Medicaid contracting preferred. + Experience in fee schedule development using actuarial models ... Network Management Sr** **(** Hospital Contracts) develops the provider network through contract negotiations, relationship development , and servicing.… more