• Contract Manager

    Sedgwick (Providence, RI)
    …hospital and medical group contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to ... Taking care of people is at the heart of...or university preferred. **Experience** Four (4) years of progressive provider network contract negotiation experience or equivalent… more
    Sedgwick (12/18/24)
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  • Lead HVDC Contract Manager

    GE Vernova (Foxborough, MA)
    **Job Description Summary** Job Description Summary The Contract Manager will provide broad-based and thorough commercial contract management support to the ... Energy business, serves customers globally with over 12,000 employees. We provide power utilities and industries worldwide with equipment, systems, and services… more
    GE Vernova (01/02/25)
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  • Clinical RN Comp Care - Remote

    Sharecare (Providence, RI)
    …-effective manner while ensuring high quality care . The RN coordinates with the Primary Care Provider and all other members of the health care team to ... increasing acuity, and for intervening with the participants and their Primary Care Provider according to the disease management program intervention guidelines.… more
    Sharecare (12/17/24)
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  • Clinical Pharmacy Specialist

    Beth Israel Lahey Health (Westwood, MA)
    …the Clinical Excellence Division to improve patient outcomes and minimize total cost of care by promoting high-value, evidence-based pharmacotherapy. This is ... and value-based contract performance. The scope and nature of patient care services are focused on optimizing patients' therapeutic outcomes, and includes active… more
    Beth Israel Lahey Health (12/10/24)
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  • Contracts Specialist, Federal Government -…

    IMSolutions, LLC (Providence, RI)
    …to work at the agency's office in Washington, DC._** As a **Federal Contract Specialist** , you provide acquisition support services, including contract ... and contract closeouts. + Market research/analysis, selection and administration of contract terms and conditions, cost , and price analysis. + US Citizenship… more
    IMSolutions, LLC (11/27/24)
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  • Associate Director, Healthcare Economics

    Atrius Health (Newton, MA)
    …well. Across 32 clinical locations, more than 50 specialties and 825 physicians, we provide proactive, customized care to more than 720,000 adult and pediatric ... monitoring and reporting of outside medical costs. . Administers all medical cost /managed care analytics related to capitated arrangements with insurances… more
    Atrius Health (11/29/24)
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  • Operations Manager Federal -Department of the Air…

    Lumen (Providence, RI)
    …price, cost plus fixed fee, cost plus award fee and cost reimbursable contract line-item numbers (CLINs). + Provides guidance and direction to assigned ... Modernization Program (BIM) is a multi-award indefinite delivery/indefinite quantity (ID/IQ) contract in support of AF Base Area Network (BAN) efforts to… more
    Lumen (12/11/24)
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  • Fraud Waste and Abuse (FWA) Audit Manager

    Fallon Health (Worcester, MA)
    …a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon ... Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical… more
    Fallon Health (11/09/24)
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  • Senior Infrastructure Manager, Americas

    Olympus Corporation of the Americas (Westborough, MA)
    …providers, negotiating contracts and ensuring service-level agreements (SLAs) are met. + Provide guidance to Infrastructure Provider Manages in third party ... True to Life, by advancing medical technologies and elevating the standard of patient care so people everywhere can fulfill their desires, dreams, and lives. ​ Our… more
    Olympus Corporation of the Americas (12/04/24)
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  • Liability Claims Team Lead

    Sedgwick (Providence, RI)
    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 ... technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide more
    Sedgwick (12/24/24)
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  • Inpatient Medical Coding Auditor

    Humana (Providence, RI)
    …Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims ... coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are… more
    Humana (12/12/24)
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  • Senior Project Manager Construction - Constructiv…

    Generac Power Systems (Marlborough, MA)
    …project, including sub-consultants, sub-contractors, site management team, design team, contract administration, construction accounting, and others, to ensure the ... Ensure consistency of deliverables to meet the Standard of Care . + Provided client and team leadership to drive...meetings. + Plan, organize and staff key positions and provide overall supervision and management of project(s), including ensuring… more
    Generac Power Systems (11/09/24)
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  • Vice President, Medicare Stars Program

    Point32Health (Canton, MA)
    …a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are ... heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care , where we leverage our experience and expertise to help people find their… more
    Point32Health (01/03/25)
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  • Director, Insurance

    Brown University (Providence, RI)
    …self -insured workers' compensation program. Ensure effective program management to provide quality care for Brown's employees including innovation in ... Develop and manage an overall University-wide insurance program in order to provide insurance protection the University, its employees and related organizations from… more
    Brown University (12/21/24)
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  • Auto Claims Adjuster (Per Diem/Remote)

    Sedgwick (Providence, RI)
    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 (01/01/25)
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  • Director Healthcare Economics & Trend Analytics

    Baylor Scott & White Health (Providence, RI)
    **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White ... to uncover trends and assist in managing and understanding incurred medical and pharmacy cost . - The Director will design, develop, and support the creation of core… more
    Baylor Scott & White Health (12/21/24)
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  • Director Clinical Account Services - Remote Nevada

    Prime Therapeutics (Providence, RI)
    …and satisfaction. Develops and tracks appropriate metrics that monitor the quality and care cost impact of the clients' program. Provides guidance, assistance ... all clinical recommendations is essential for both the client's cost of care and the overall administration...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
    Prime Therapeutics (11/06/24)
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  • Director Account Management, PACE - Remote

    Prime Therapeutics (Providence, RI)
    …+ Book of Business and Financial Management: Ensures revenue goals are met, cost of care and administrative expenses managed, and (Earnings before Interest, ... contracts with assigned customers as well as ensuring ongoing contract performance through risk management activities including assurance of...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
    Prime Therapeutics (12/19/24)
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  • Rebate Analyst Sr

    Prime Therapeutics (Providence, RI)
    …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
    Prime Therapeutics (01/01/25)
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  • Claims Representative - Auto

    Sedgwick (Providence, RI)
    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
    Sedgwick (12/20/24)
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