- CACI International (Sterling, VA)
- Network Problem Management Quality ...Develop and maintain quality standards for problem management processes + Provide training and guidance ... * * * **The Opportunity** : We are seeking an experienced ITIL Network Problem Management Quality Assurance Lead to ensure the effectiveness and efficiency… more
- House of Representatives (Washington, DC)
- …Support; Knowledge of Emerging Trends and Industry Best Practices; Network Management ; Project Management ; Quality Assurance and Testing; and ... and administrative counsel. The incumbent provides systems administration and configuration management support for data network hardware and software components… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …broad range of critical strategic business initiatives within the scope of primary care network development and management , and quality and patient safety. ... education/orientation, clinical integration, evaluation of network adequacy, quality , and performance metrics. Collaborates with provider relations… more
- Commonwealth Care Alliance (Boston, MA)
- …Experience:** + 5-7 years of experience in healthcare quality improvement, provider network performance and management , population health, or related ... of Delegation Partnerships and Performance, is responsible for advancing provider quality performance across CCA's contracted network , with a focus on… more
- AmeriHealth Caritas (Washington, DC)
- … satisfaction, education, and communication. This position is also responsible for all provider network recruiting and contracting management activities as ... Responsible for managing the day-to-day activities of the DC Medicaid Plan Network Management department and staff. Responsible for assisting the Leader… more
- AmeriHealth Caritas (Charleston, SC)
- **About the job:** The Manager of Provider Network Management manages the Network Management department's and staff's day-to-day activities. ... and communication. This position is also responsible for all provider network recruiting and contracting management...and managing the day-to-day activities of the Account Executives, Quality Practice Advisors and Provider Network… more
- Manulife (Boston, MA)
- …Administration, Public Policy, or related field preferred + 8 -15+ years in provider network management , healthcare contracting, or payer strategy roles ... to our customers when they need it. The Director, Provider Network Development & Relationship Management...& Performance Management : Track, monitor and manage network performance metrics, data quality , and KPIs;… more
- AmeriHealth Caritas (Southfield, MI)
- … comprehensive senior leadership and strategic direction to the market network management teams in developing and maintaining effective, high-performing ... contract all hospital, physician, ancillary, facility, and physician extender network development and management for all products...related aspects of state contract. + Leads and manages provider network team to ensure high performance,… more
- AmeriHealth Caritas (Baton Rouge, LA)
- … management of provider satisfaction. + Contractors will work with Corporate Provider Network Management to manage the annual contracting schedule as ... departmental policies. + Ensures contracts are supportive of Plan quality initiatives such as HEDIS, CAHPS and NCQA/URAC. +...claim payment methodologies. + Augments and modifies the existing provider network to accommodate new products or… more
- Corewell Health (Grand Rapids, MI)
- …+ Preferred Master's Degree (MBA, MHA, MHP) + 5 years of relevant experience within provider network management , health care insurance or other health care ... costs, cost-savings opportunities, best practices, provider performance issues, provider compensation and network expansion. + Support market specific… more
- UPMC (Media, PA)
- …optimal clinical and quality outcomes for members. + Works with Member Services, Network Management and Quality Management staff to assure that ... solves based on advanced-level knowledge of the service delivery system, the provider network , member services policies, members' rights and responsibilities,… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …through our Healthsource blog: https://healthsource.premera.com/ . **_About the role of Senior Provider Network Executive_** The **Sr. Provider Network ... the **PNE IV** is responsible for the negotiation and management of Premera's most complex and critical provider...Premera product knowledge to foster a collaborative approach to quality care, network stability and cost containment.… more
- Point32Health (NH)
- …of regulatory requests. + Coordinates and oversees the annual re-contracting of the provider network for commercial business. + Works with other departments, ... and analysis of new reimbursement strategies and financial analytics supporting provider contracting in the Point32Health network . + Summarize findings… more
- UPMC (State College, PA)
- …optimal clinical and quality outcomes for members. + Works with Member Services, Network Management and Quality Management staff to assure that ... solves based on advanced-level knowledge of the service delivery system, the provider network , member services policies, members' rights and responsibilities,… more
- AmeriHealth Caritas (Southfield, MI)
- …+ Support overall network development and network management strategies. + Assist departmental leadership with provider satisfaction, education, ... **Role Overview:** The Senior Provider Network Account Executive is responsible...Executives (AEs). + Lead and support hospital and physician network development and management , including participation in… more
- Corewell Health (Grand Rapids, MI)
- …Master's degree, MBA, MHA, MHP Preferred. + Three years of relevant experience within provider network management , health care insurance or other health care ... and advancement while maintaining seniority and benefits. About the RoleAs Manager of Provider Network Contracting, you will partner with the Director to lead… more
- Molina Healthcare (Pensacola, FL)
- …to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. ... and will work EST business hours M-F Job Summary Provides support for provider network administration activities. Responsible for accurate and timely validation… more
- AmeriHealth Caritas (Miami, FL)
- …Quality Management team on credentialing, re-credentialing, member complaints, and quality of care investigations. + Maintain accurate provider data in ... provider onboarding and educational sessions, and issued resolutions to support provider engagement and satisfaction. + Monitor network adequacy and ensure… more
- Omaha Children's Hospital (Omaha, NE)
- …and people with disabilities. **A Brief Overview** The Program Manager for Community Provider Network Relations is responsible for the support and maintenance of ... a regional network of community providers (the " Network "). The Program Manager (PM) will provide ...collaboration efforts. + Assist in the responsibility of the network 's annual budget development and management within… more
- Humana (Phoenix, AZ)
- …to work with internal and external constituents on all areas of contracting; network management ; adequacy and gaps; provider education; conflict resolution; ... of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other… more
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