- Butterball (Warsaw, NC)
- …candidates should read through the following details of this job with care before making an application. Responsible for multi-plan contractual purchases and ... a corporatewide vendor network and inventory control system, preparing cost spreadsheets, creating presentations, completing vendor review evaluations, and… more
- Elevance Health (Winston Salem, NC)
- ** Provider Contract Cost of Care Consult Senior / VBC** **Location:** This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consult...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Durham, NC)
- ** Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration ... granted as required by law. The ** Provider Contract Cost of Care Analyst...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- CVS Health (Raleigh, NC)
- …to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. **Required Qualifications** + 3 + ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...years experience with provider contract negotiation or provider … more
- UNC Health Care (Butner, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... problem-solving, decision-making, and evaluating clinical/system issues and models of care . Leads interdisciplinary teams to provide integrated delivery… more
- UNC Health Care (Raleigh, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... guidelines and other regulatory and accreditation standards. **Join our growing UNC Urgent Care provider team! This is an employed position with UNC Rex… more
- UNC Health Care (Morrisville, NC)
- … cost models for departments, service lines, procedures, and payers. + Provide actionable insights to support pricing strategies, contract negotiations, and ... the unique communities we serve.** **Summary:** This position leads the system-wide cost accounting and decision support function for an integrated healthcare system… more
- CVS Health (Raleigh, NC)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... all with heart, each and every day. **Position Summary** The Lead Director, Provider Portal Strategy & Operations is responsible for the strategic leadership and… more
- The Cigna Group (Charlotte, NC)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team… more
- UNC Health Care (Morrisville, NC)
- …COO, CAO/CFO). This leader will develop and implement a program to advance high quality/low- cost health care delivery to support the mission and core values of ... strategy for regional and statewide clinical integration, maximizing value contract performance management, fostering payor relationships, and evaluating advanced… more
- Elevance Health (Charlotte, NC)
- …for overseeing and monitoring healthcare services to insure quality, compliance, and cost -effectiveness. Coordinate care across providers and settings to improve ... plans and ensure they are appropriate, high quality, and cost -effective. + Coordinate care between delegated ...determinants of health, to meet the member's needs and provide patient education. + Escalate member crises, or quality… more
- Novant Health (Wilmington, NC)
- …Responsible for ongoing quality, productivity and efficiency in Wound Ostomy Care Services. + Leadership: Provide coordination for wound/ostomy/continence ... and on the best science, best service and best cost . Improve the outcomes of patients with wounds, ostomy...evaluate cast effective quality and regulatory initiatives. + Patient Care & Education Counseling: Provide education to… more
- UNC Health Care (Goldsboro, NC)
- …matters relating to physician performance . h. Leads Medical Staff improvements in care transitions, care standards, cost reduction initiatives, resource ... among the various clinical components of Wayne UNC Health Care with a goal of providing high quality, efficient...for the provision of services; coordinates across departments to provide a maximum level of services to patients, family,… more
- Elevance Health (Bryson City, NC)
- …applicable state law and contract . **How you will make an impact:** + Provide integrated whole-person Care Management under the CFSP Care Management ... **CFSP Managed Care Coordinator** **Sign-on Bonus: $2500** **We are currently...of members with chronic illnesses, co-morbidities, or disabilities for cost -effective and efficient service utilization. + Set short- and… more
- Elevance Health (Gastonia, NC)
- …goals as identified during assessment. + Supports member access to appropriate quality and cost effective care and modifies plan(s) as needed. + Coordinates with ... \#HealthyBlueCareTogetherCFSP **Clinical Care Advisor - Prevention and Preservation** **$3,500 SIGN...accordance with federal/state law, scope of practice regulations or contract , the requirements are:** + Requires MS/MA in social… more
- UNC Health Care (Chapel Hill, NC)
- …counseling and clarification of insurance issues to help facilitate access to and provide continuity of care for transplant patients. The Transplant Financial ... and pharmacy representative to ensure that patient is receiving care as defined by the contract . Contacts...with patient and/or family members with emphasis on the cost of transplantation. Advises patient on how to apply… more
- Highmark Health (Raleigh, NC)
- …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... 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
- UNC Health Care (Raleigh, NC)
- …scale projects, and recommend proposals as appropriate to upper management. Develop cost estimates and provide recommendations for corrective work. 7. Negotiate ... the facilities and spaces owned, leased, and maintained by the UNC Health Care System. Responsibilities: 1. Assess and Manage work priorities and goals for ongoing… more
- Elevance Health (NC)
- **Behavioral Health Care Manager I - (Day Shift)** **Location** **- Virtual:** This role enables associates to work virtually full-time, with the exception of ... 9am-6pm EST + Monday-Friday 11am-8pm EST The **Behavioral Health Care Manager I - (Day Shift)** is responsible for...access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines… more
- Elevance Health (NC)
- **Behavioral Health Care Manager I - North Carolina** **Sign on Bonus: $3,500** **Location** **- Virtual:** This role enables associates to work virtually full-time, ... Sunday 8:00 AM - 8:00 PM. The **Behavioral Health Care Manager I - North Carolina** is responsible for...access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines… more
