- CVS Health (Columbus, OH)
- …and/or behavioral health experience preferred. + Proven working knowledge of physician reimbursement methodologies and contracting strategies. + Strong ... analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health providers in accordance with company… more
- Trinity Health (Muskegon, MI)
- …QUALIFICATIONS** **Education** Minimum: High school diploma/ GED with 5 year's of physician contracting experience or associate's degree or Bachelor degree with ... Type:** Full time **Shift:** **Description:** **POSITION PORPOSE** + The ** Physician and Clinical Contract Specialist** serves as the lead... and clinical services. + May serve as project manager for assessing new service lines and work with… more
- Defense Health Agency (Lackland AFB, TX)
- **Overview** Physician Assistant Wilford Hall Ambulatory Surgical Center, San Antonio Time to invest in some new footwear because if you're San Antonio-bound, you'd ... robust job market that seems partial to government and defense/security contracting ensures employment opportunities for spouses or transitioning service members.… 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 ... to improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible for driving key population… more
- Molina Healthcare (NV)
- …Nevada _** **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 standard deals, maintaining network adequacy, issue… more
- Molina Healthcare (MS)
- …managed healthcare setting ideally in negotiating different provider contract types, ie physician , group and hospital contracting , etc. * Working experience with ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and...various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of… more
- Molina Healthcare (Sterling Heights, MI)
- …managed healthcare setting ideally in negotiating different provider contract types, ie physician , group and hospital contracting , etc. * Working familiarity ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to… more
- AbbVie (Mettawa, IL)
- …or related industry. The role provides insights that directly impact patient and physician access to AbbVie brands through its influence on the development of ... pricing, contracting and other access strategies. MAJOR RESPONSIBILITIES Execute standard...requirements under state or local law: + The compensation range described below is the range of possible… more
- Omnicell (Grapevine, TX)
- **Summary** The Manager of Licensing & Credentialing supports the OSPS PSAO through various functions, including but not limited to providing day-to-day management ... and heat zones. + Oversees new pharmacy credentialing and enrollment. **PBM/Payor Contracting and Audit Team** + Provides oversight of daily activities to manage… more
- Texas Health Resources (Dallas, TX)
- …Position exists to provide support for THPG leadership primarily relative to physician compensation modeling/review and includes reporting and analysis, provider ... is a priority + Opportunity to learn industry leading compensation software + Wide scope of contracting ...variety of project-oriented tasks and supports the routine monthly physician compensation payroll calculations and data integrity… more
- AbbVie (Mettawa, IL)
- …(GPO) environment. The role provides insights that directly impact patient and physician access to AbbVie Oncology brands through its influence on the development ... of GPO contracting and other access strategies. Lead analytics and insights...under state or local law: + The compensation range described below is the range of possible… more
- Elevance Health (Sacramento, CA)
- **JR134950 Provider Network Manager ** Develops the provider network through contract negotiations (language and rates), relationship development, and servicing. ... **How will you make an impact:** + Primary focus of this role is contracting and negotiating contract terms. + Provider contracts are amended twice a year. +… more
- Maxim Healthcare Services (Albuquerque, NM)
- Maxim Healthcare Group is currently seeking an Operations Manager . The Operations Manager is responsible for successfully managing and leading the complete ... operations of a Maxim branch office. The Operations Manager has an integral role in the ongoing education... leads the quality improvement process, program development, and contracting with new customers while maintaining compliance with all… more
- Molina Healthcare (Grand Rapids, MI)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to ... provider information on all claims and provider databases. Responsible for contracting /re- contracting of standard deals, maintaining network adequacy, issue… more
- Trinity Health (Boise, ID)
- …departments including shared services, data analytics, finance, credentialing, and contracting . Leads the process for completion of Alliance Participation ... and ensuring network providers and internal colleagues understand payer and physician participation requirements. Assists the Regional Director and President as… more
- CVS Health (Sacramento, CA)
- …affordable. **Position Summary** Negotiate and maintain a broad portfolio of physician contracts in Northern CA. Responsible for negotiation, execution, review, and ... fee-for-service contracts and/or handles dispute resolution and settlement negotiations with physician groups in the California market; for lines of business… more
- Elevance Health (Atlanta, GA)
- The Provider Network Manager is develops the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary ... focus of this role is contracting and negotiating contract terms. Typically works with less-complex...providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of… more
- AdventHealth (Tampa, FL)
- …related to maintaining institutional and program accreditation, HR functions regarding physician and resident recruitment, contracting , onboarding, and mandatory ... Primary Stroke Center. **The role you'll contribute:** The GME Manager is responsible for day to day management of...Serve as liaison to FH HR, FHMG, and AHS contracting team and AHS Risk department to ensure eligibility… more
- Mount Sinai Health System (New York, NY)
- …to Case Managers and other hospital personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management, Managed Care Contracting and other ... **Job Description** The Nursing Clinical Manager (NCM) for Case Management is responsible for...review medically complex and long stay cases; refer to physician advisor as indicated. 3. Collaborates with Social Work… more
- Cedars-Sinai (CA)
- **Job Description** The Program Manager is responsible for supporting all facets of the program initiative, under the supervision of the department management. ... + Monitors and tracks HMO enrollment by payor, line of business and physician for trends and anomalies. Works with Utilization Management and Medical Directors to… more