- Molina Healthcare (Kenosha, WI)
- …contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. ... Job Description Job Summary Molina Health Plan Provider Network Contracting jobs are responsible...with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost… more
- Elevance Health (Waukesha, WI)
- ** Cost of Care / Provider Contracting Data Analyst** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... an accommodation is granted as required by law. The ** Cost of Care / Provider Contracting...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Waukesha, WI)
- …for providing the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you will make an impact:** ... cost of care . + Educates provider contractors on contracting analytics from a...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Molina Healthcare (Milwaukee, WI)
- …previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes… more
- Molina Healthcare (Milwaukee, WI)
- …out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. * ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost… more
- Molina Healthcare (Milwaukee, WI)
- …efficient, cost -effective, and minimally restrictive. This role involves defining provider requirements and expectations, setting provider goals and plans ... It is an external-facing, field-based position requiring an in-depth knowledge of provider relations and contracting subject matter expertise to successfully… more
- Molina Healthcare (Milwaukee, WI)
- …customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare provider ... negotiating different provider contract types, ie, physician, group and hospital contracting , etc. To all current Molina employees: If you are interested in… more
- Molina Healthcare (Milwaukee, WI)
- …health plans on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Milwaukee, WI)
- …health plans on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Milwaukee, WI)
- … care in the most effective setting. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... clinical criteria competency. * Peer review, medical policy/procedure development, and provider contracting experience. * Strong verbal and written communication… more
- Molina Healthcare (Milwaukee, WI)
- …senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations ... in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment,… more
- CDM Smith (Milwaukee, WI)
- … cost estimates and supporting analysis in coordination with government cost estimators and contracting officers. * Participate in pre-construction meetings, ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- Molina Healthcare (Milwaukee, WI)
- …etc. **PREFERRED EXPERIENCE:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, ... through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care . + Ensures that… more
- Clarios (Milwaukee, WI)
- …Procurement strategies, including: identifying key suppliers, market influencers on cost , technology opportunities, risks and strategic direction, etc. * Lead ... supply market analysis, supplier analysis, RFI/RFP building, baseline analysis, contracting , outsourcing & offshoring, product lifecycle management, building business… more
- Molina Healthcare (Milwaukee, WI)
- …for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates. + Assist ... interpolation, and other statistical methodologies to predict future trends in cost , utilization, and performance. + Assist with research, development and completion… more
