- Commonwealth Care Alliance (Boston, MA)
- …position partners closely with provider engagement, delegation partnerships, provider services, contracting , quality, compliance, medical management, and ... with organizational priorities. - Foster a culture of continuous improvement, professional development, and high performance within the provider relations… more
- Elevance Health (Morristown, NJ)
- …Requirements: Requires a BA/BS degree and a minimum of 3 years of experience in contracting , provider relations, provider servicing ; or any combination of ... member of the Elevance Health family of companies, Carelon Behavioral Health , offers superior clinical mental health and...and insightful analytics to improve the delivery of care. Provider Network Manager - New Jersey * This is… more
- Commonwealth Care Alliance (Boston, MA)
- …and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital, behavioral health, ... Provider Network Management staff to ensure an adequate and appropriate provider network When necessary, participate in contracting strategy discussions… more
- Highmark Health (Washington, DC)
- …cross organizational programs and projects 5 years Familiarity with health plan and provider contracting or revenue management 2 years Understanding of ... to drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark… more
- 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 ... Long-Term Services and Supports (LTSS) provider organizations that serve One Care and Senior Care...metrics. + Collaborate with Business Intelligence, Finance, Quality, and Contracting to develop and disseminate performance reports and dashboards.… more
- University of Pennsylvania (Philadelphia, PA)
- …News & World Report survey. Penn has 12 highly-regarded schools that provide opportunities for undergraduate, graduate and continuing education, all influenced by ... and their families, generous retirement benefits, a wide variety of professional development opportunities, supportive work and family benefits, a wealth of… more
- The Cigna Group (Denver, CO)
- Summary We are seeking a self-motivated business analytics or actuarial professional with a passion for problem solving and a strong desire to learn, lead and ... our growing team. This role will work collaboratively with Network Analytics, Contracting , Competitive Intelligence, IT, and other matrix partners to support our… more
- Commonwealth Care Alliance (Boston, MA)
- …critical measures. The role supports efforts of the organization's Network and Provider Contracting department and will have regular interaction with relevant ... 011230 CA- Provider Engagement & Performance **Position Summary:** The HEDIS...of HEDIS and Health Plan quality initiatives; familiarity with behavioral health KPIs such as IET and FUH +… more
- Teleflex (Philadelphia, PA)
- …More than 50% **Requisition ID** :13098 **About Teleflex Incorporated** As a global provider of medical technologies, Teleflex is driven by our purpose to improve ... Participate in field sales calls with Sales Representatives on a weekly basis. - Provide open and honest feedback on quality of work material/progress to goals and… more
- The Cigna Group (St. Louis, MO)
- …and guidance on complex clinical rebate modeling assignments/projects and provide financial rebate modeling support to assigned clients. Exercises considerable ... and judgment in conceiving, planning, and delivering initiatives. Uses clinical professional knowledge and acumen to advise functional leaders and educate other… more
- Zeiders Enterprises, Inc (Woodbridge, VA)
- …market and competitive research; develop customer and competitor profiles; and provide data-driven recommendations for bid/no-bid decisions. + Identify, develop, and ... including subordinate managers, support consultants, and BD staff). + Provide leadership to cross-functional capture teams, exercising influence without direct… more
- WellSpan Health (York, PA)
- …new hospital additions as applicable, in accordance with System Care Contracting Team. Includes all traditional medical components (hospital, WMG, Apple Hill, ... home infusion, VNA, DME) and Value-Based Purchasing. + Collaborates with contracting leadership to identify and understand challenging operational issues with payor… more
- Elevance Health (Sacramento, CA)
- ** Behavioral Health Community Partnership Manager** **( Behavioral Health Provider Quality Manager)** **Sign on Bonus: $2,500** **Candidates must posses a ... insightful analytics to improve the delivery of care. The ** Provider Quality Manager** is responsible for leading Behavioral...face to face, telephonically, and via Web-Ex to support provider training on Carelon processes, contracting /… more
- CVS Health (Harrisburg, PA)
- …behavioral health program development. + Familiarity with value-based care models and provider contracting . **Education & Licensure** + Master's degree in ... The Behavioral Health Coordinator is a licensed mental health professional responsible for supporting behavioral health program development for CHIP… more
- BrightSpring Health Services (San Antonio, TX)
- …Disabilities (IDD) Division. Theideal candidatewill have B2B sales and Behavioral Health and Individuals with Developmental Disabilities (IDD) Care experience, ... communicating (verbally and in writing) with IDD agencies and behavioral health organizations to assess market needs + Works...needs + Works with RVP of Sales in finalizing contracting , coordinating startup of new account and transitioning account… more
- Commonwealth Care Alliance (Boston, MA)
- …position partners closely with provider engagement, delegation partnerships, provider services, contracting , quality, compliance, medical management, and ... with organizational priorities. * Foster a culture of continuous improvement, professional development, and high performance within the provider relations… more
- PeaceHealth (Bellingham, WA)
- …to SBC encounter. + ITA- monitor for change of status and notify payer. + Provide admission support to Behavioral Health unit/ED/SECU as needed. Assist MSW with ... **Description** PeaceHealth is seeking a RN Admissions/Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary range for… more
- Highmark Health (Oklahoma City, OK)
- …cross organizational programs and projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2 years Understanding of ... to drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark… more
- Blue KC (MO)
- …+ Partner with contracting , product, and network operations to align provider performance, incentives, and reporting structures with behavioral and health ... **Guided by our core values and commitment to your success, we provide health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some… more
- World Wide Technology (St. Louis, MO)
- **Sr. Sourcing Professional ** **Why WWT?** At World Wide Technology, we work together to make a new world happen. Our important work benefits our clients and ... Founded in 1990, WWT is a global technology solutions provider leading the AI and Digital Revolution. WWT combines...successful candidate for this role would exhibit the following behavioral skills:** + Achievement oriented with a strong drive… more
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