- The Cigna Group (Plano, TX)
- …market - can live in Houston, San Antonio, Dallas or Plano** The ** Director , Provider Contracting - Medicare ** serves as an integral member of the ... Network Development and Strategy Team and reports to the Provider Contracting Senior Manager. This role is...in lieu of a bachelor's degree. + **5+ years Medicare experience required.** + **5+ years Contracting … more
- Molina Healthcare (Dallas, TX)
- …Services functions with an emphasis on contracting , education, outreach and resolving provider inquiries. * In conjunction with the Director , Provider ... Network Management & Operations, develops health plan-specific provider contracting strategies, identifying specialties and geographic locations on which to… more
- Molina Healthcare (Dallas, TX)
- …etc. **PREFERRED EXPERIENCE:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare ,… more
- CVS Health (Irving, TX)
- …+ Medicaid product pricing + Health Plan Operations + Provider contracting and reimbursement methodologies + Medicaid, Medicare or Commercial health ... and presenting new opportunity business cases to senior leaders + Provider contracting negotiations, including fully/partially capitated, value-based, risk… more