- Avera (Des Moines, IA)
- …Forward for you and our patients. Work where you matter.** **A Brief Overview** The Provider Contract Manager is a critical member of Avera Health Plans (AHP) ... implementation of broad based, tiered, and narrow network products and value-based contract arrangements. Also lead medical cost reduction programs to identify… more
- Molina Healthcare (Des Moines, IA)
- …care , or other health care field. **Required Experience** 3 - 5 years provider contract negotiation experience in the health care field including, but ... QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider 's office,… more
- Molina Healthcare (Des Moines, IA)
- …Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Utilizes standardized contract ... sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members. *...concert with Director. * Oversees the maintenance of all Provider and payer Contract Templates. Works with… more
- UMB Bank (Des Moines, IA)
- …Risk, Compliance, Information Security, Finance, and Business Operations to ensure contract terms meet applicable standards and adequately protect UMB interests. You ... renewals, software license, maintenance, support, subscriptions, and/or other third-party contract commitments. Working for UMB is about collaborative spirit with… more
- Cayuse Holdings (Des Moines, IA)
- …offering a varied set of business lines, workforces, and credentials to provide solutions for government clients throughout the world. Our companies have years ... projects, and commitment to excellence. **The Work** The Cayuse Government Contract Pricing Specialist is a Pricing and Estimating professional who assesses… more
- Molina Healthcare (Des Moines, IA)
- …with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. + Maintains contractual relationships with ... systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. **KNOWLEDGE/SKILLS/ABILITIES** + In conjunction with … more
- Highmark Health (Des Moines, IA)
- …years Experience working in an Actuarial Science capacity + 2 years Understanding of provider contract documents and overall contract management process + 1 ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …* Provide training to DNR program staff, as requested, by DNR supervisors Provide Contract Oversight & Coordination: *Review draft DNR service contracts, ... and minor (under $100,000) construction procurements through formal solicitation and provide recommendation for contract award to Engineering Bureau Chief… more
- Sedgwick (Des Moines, IA)
- …Surety Claims Advisor **PRIMARY PURPOSE** **:** To analyze complex or technically difficult contract surety bond claims; to provide resolution of highly complex ... Taking care of people is at the heart of...RESPONSIBILITIES** + Analyzes and processes complex or technically difficult contract surety (pay and performance) claims by investigating and… more
- CVS Health (Des Moines, IA)
- …+ Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/Claims Research Medicaid team. Extensive claims research ... framework to make financial decisions to resolve provider issues. Explain provider 's rights and responsibilities in accordance with contract . + Process claim… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …team. You will serve as personal secretary to the State Public Defender and provide a broad variety of administrative tasks for the administrative office staff. Some ... to or route inquiries to the State Public Defender or appropriate staff. Provide a bridge for smooth communications with staff, statewide SPD offices and other… more
- Black & Veatch (Des Moines, IA)
- …develop and implement the proposal win strategy on key opportunities. + Participate in cost review and influences team to provide responses with competitive ... a team of proposal managers with responsibilities from pursuit assignment to contract signing. + Manage team workload and proposal assignment activities. +… more
- Prime Therapeutics (Des Moines, IA)
- …solutions to Prime's clients to ensure Prime is delivering the highest quality and lowest cost of care to its members. The Trade Client Relations Senior Director ... of rebate guarantees, pharmaceutical manufacturer rebate agreements and drug trends; provide proactive strategic and cost saving consultation + Provides… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …with state and federal laws and regulations, program guidelines, and grant or contract requirements. + Provide support in designing more effective compliance and ... of Ethics of the Institute of Internal Auditors. + Provide audit services that are impartial, unbiased, free of...federal laws and regulations, program guidelines, and grant or contract requirements. + Investigate the facts and circumstances of… more
- Sedgwick (Des Moines, IA)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... benefits due, and manages action plan pursuant to the claim or client contract . + Manages subrogation of claims and negotiates settlements. + Communicates claim… more
- Sedgwick (West Des Moines, IA)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... exposures, litigation, and catastrophic injuries. Will also monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide … more
- Elevance Health (Fort Dodge, IA)
- …with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. + Manages non-clinical needs of members ... (PCSP) and backup plan, interfacing with Medical Directors and participating in interdisciplinary care rounds to support development of a fully integrated care … more
- Prime Therapeutics (Des Moines, IA)
- …empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If ... area of Prime Therapeutics. This position is also responsible for assisting contract negotiators and working with other internal departments regarding the financial… more
- Sedgwick (Des Moines, IA)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... manages action plan pursuant to the claim or client contract . + Manages subrogation of claims and negotiates settlements....not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in… more
- Sedgwick (Des Moines, IA)
- Taking care of people is at the heart of...Develops and maintains action plans to ensure state required contract deadlines are met and to move the file ... everything we do, and we start by taking care of you, our valued colleague. A career at...not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in… more