- Prime Therapeutics (Jefferson City, MO)
- …changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract ... rate/funding changes. + Develops and implements process for monitoring provider contract compliance and performance based ...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Prime Therapeutics (Jefferson City, MO)
- …changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract ... rate/funding changes. + Develops and implements process for monitoring provider contract compliance and performance based ...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Prime Therapeutics (Jefferson City, MO)
- …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 ... passion and drives every decision we make. **Job Posting Title** Maximum Allowable Cost Programs Specialist - Remote **Job Description Summary** The purpose of this… more
- CVS Health (Jefferson City, MO)
- …will: + Drive the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. + ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Humana (Jefferson City, MO)
- …us put health first** The Delaware Valley ACO (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' ... the program may include rotations through various DVACO departments including Care Coordination, Practice Transformation, Data Analytics, Post-Acute Care and… more
- Centene Corporation (Jefferson City, MO)
- …mental and behavioral health needs members to provide high quality, cost -effective healthcare outcomes including personalized care plans and education for ... between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services...RN with BH experience required + For Illinois Youth Care Contract : Master's degree in social sciences,… more
- Option Care Health (Jefferson City, MO)
- …alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly ... resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than...treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through… more
- Centene Corporation (Jefferson City, MO)
- … management team to achieve cost -effective healthcare results + Works with care management senior management to provide updates and insights on care ... behavioral health members to develop and assess high quality, cost -effective healthcare outcomes related to mental and behavioral health... care management team to improve member and provider experience and high-quality care + Educates… more
- HomeSafe Alliance (Jefferson City, MO)
- …include but not limited to schedule, delivery, performance, quality, safety, cost control, P&L, Service Provider relationships, and customer satisfaction. ... GHC prime contractor and household goods moving service integrator, we provide earlier visibility into upcoming moves and greater network throughput… more
- IMSolutions, LLC (Jefferson City, MO)
- …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
- Highmark Health (Jefferson City, MO)
- …configurations and onboarding of new plans/providers. Translates configuration rules, fee schedules, contract terms, provider data code sets, and benefits into ... to benefits, business rules, screen design and functionality, templates, workflows, provider contracts, user task analysis, personalization to different plans, and… more
- CVS Health (Jefferson City, MO)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. *Position is fully remote and open to… more
- Planate Management Group LLC (Jefferson City, MO)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... quality control, and submittal reviews beyond the expertise of construction managers + Provide quality assurance for ongoing projects, and serve as a mentor to fewer… more
- Prime Therapeutics (Jefferson City, MO)
- …of data. + Supports the account management team ensuring revenue goals are met, cost of care and administrative expenses are managed and segment profit targets ... assigned account (s). + Demonstrates a thorough knowledge of Cost of Care and implications internally and...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Elevance Health (Jefferson City, MO)
- …to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care through assessing the medical of inpatient admissions, ... member access to medical 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
- Prime Therapeutics (Jefferson City, MO)
- …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 ... is responsible for performing multifaceted financial analyses to assess manufacturer contract performance, plan performance and to develop rebate estimates related… more
- Sedgwick (Jefferson City, MO)
- 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
- Planate Management Group LLC (Jefferson City, MO)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... generation, and plumbing. Key responsibilities: + Designing and implementing cost -effective equipment modifications to help improve safety, reliability and… more
- Intermountain Health (Jefferson City, MO)
- …case development, financial modeling, and the related analysis and total cost of ownership understanding and analysis, implements demand management strategies, ... regulatory compliance tracking. Leads the dispute resolution process on contract items and ensures a high level of ...sourcing and / or category management within the health care industry. - and - Healthcare product knowledge **Physical… more
- Elevance Health (Jefferson City, MO)
- …resources for more complex medical issues. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process. +… more