- Elevance Health (Mason, OH)
- ** Provider Contract / Cost of Care Consultant Senior** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration ... an accommodation is granted as required by law. The ** Provider Contract / Cost of Care...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- Elevance Health (Mason, OH)
- …office. **Position Overview:** Provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses ... develop contracting strategy and supports all aspects of the contract negotiation process. Works with multiple provider ...modifications as applicable + Recommends standardized practices to optimize cost of care + Educates provider… more
- Elevance Health (Cincinnati, OH)
- Provider Success Consultant Sr. (Ohio Market) **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... This position will require the candidate to travel to provider locations in Ohio at a minimum of 50%...at a minimum of 50% of the time. **The Care Consultant Sr.** is responsible for fostering long-term partnerships… more
- Molina Healthcare (Cincinnati, OH)
- …service area.). **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract , network development and management, or project ... provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare... Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare… more
- Molina Healthcare (Cincinnati, OH)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Cincinnati, OH)
- …supports assigned contracts with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes reports according to ... 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 (Cincinnati, OH)
- …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more
- Molina Healthcare (Cincinnati, OH)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. * Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Molina Healthcare (Cincinnati, OH)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. + Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Elevance Health (Cincinnati, OH)
- …service coordinator and other clinical healthcare management and interdisciplinary teams to provide care coordination support. + Manages non-clinical needs of ... is responsible for supporting the LTSS Transition Coordinator (or contracted provider ) in contributing to the components of the person-centered planning process,… more
- City of Cincinnati (Cincinnati, OH)
- …Participates in the development and administration of assigned program budget. Create cost estimates and other contract documents. Identify and apply for ... phases of multiple projects.? Check construction plans, design calculations, or cost estimations to ensure completeness, accuracy, or conformity to engineering… more
- Bon Secours Mercy Health (Cincinnati, OH)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... responsible for managing and leading 340B Program Analysts and Auditors who provide supportive services for respective covered entities, child sites, and contract… more
- Elevance Health (Mason, OH)
- …resources for the most complex or elevated issues. Ensures clinically, high quality, cost effective care through assessing the coding of inpatient admissions, ... + Ensures member access to quality healthcare in a cost effective setting according to contract . +...or any combination of education and experience, which would provide an equivalent background. + Prior managed care… more
- Elevance Health (Mason, OH)
- …more complex medical transplant issues. + Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... member access to medically necessary, quality healthcare in a cost effective setting according to contract . +...and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management… more
- CDM Smith (Cincinnati, OH)
- …federal background check. * Knowledge of design review, construction administration, cost estimating, scheduling, and contract management. * Demonstrates ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- Curtiss-Wright Corporation (Cincinnati, OH)
- …for the performance of complex, highly technical projects in accordance with contract requirements and company policies, procedures and guidelines. You must rely on ... will be evaluated when extending an offer._ **We Take Care of Our People** ! Paid Time Off **I**...that all requirements and expectations are addressed effectively. + Provide technical input on the generation of proposals for… more
- Molina Healthcare (Cincinnati, OH)
- …of care across the continuum, and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term… more
- US Tech Solutions (Cincinnati, OH)
- …in collaboration with a dedicated team of professionals as you independently provide holistic, evidenced based care inclusive of accurate assessment, diagnosis, ... **Duration: 4+ months contract possible contract extension or conversion...Description:** + The Family Nurse Practitioner delivers defined patient care services in a retail clinic environment. + You… more
- Molina Healthcare (Cincinnati, OH)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... We are looking for Registered Nurses who have experience working with manage care population and/or case management role. Excellent computer skills and diligence are… more
- CDM Smith (Cincinnati, OH)
- …writing detailed damage descriptions. Develops and reviews scopes of work and cost estimates, including code and standard requirements. * Reviews and analyzes ... claim eligibility. Develops or evaluates hazard mitigation proposals and benefit- cost analyses. Works with applicants to prioritize their projects, facilitates… more