- ConsultNet (North Kingstown, RI)
- The Customer Care Manager supervises daily operations and team members while ensuring efficiency, cost -effectiveness, and absolute customer satisfaction in a ... complex, inbound Customer Care center. Customer Care Manager, Rx will...develop, and motivate team members to ensure that they provide a fantastic customer experience during every interaction with… more
- Prime Therapeutics (Providence, RI)
- …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 (Providence, RI)
- …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
- CVS Health (Providence, RI)
- …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 ... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. **Position Summary** Constructs negotiation, execution,… more
- 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 ... 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 (Providence, RI)
- …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 (Providence, RI)
- …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
- HomeSafe Alliance (Providence, RI)
- …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 (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
- Boys Town (Providence, RI)
- …on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider . We help our employees ... associated with the families. + Assesses problems and provides care to youth and families; monitors individual and family...regular review and update of service plans. + May provide outreach and prevention services to include increasing community… more
- Boys Town (Portsmouth, RI)
- …your job as a Family Teacher. Together each of you will be part of a team that provide care and guidance to boys and girls in need. $20,000 HIRING BONUS! up to ... able to demonstrate the knowledge and skills necessary to provide care , based on physical, psychological, psycho/social,...Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider… more
- Boys Town (Providence, RI)
- …on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider . We help our employees ... each applicant to determine eligibility; makes recommendations on placement and care and communicates potential placements to appropriate staff. + Coordinates… more
- Boys Town (Portsmouth, RI)
- …+ Must be able to demonstrate the knowledge and skills necessary to provide care , based on physical, psychological, psycho/social, educational, safety, and ... Provides direct care for at-risk youth in a safe and...Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider… more
- Highmark Health (Providence, RI)
- …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
- Boys Town (Portsmouth, RI)
- …on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider . We help our employees ... of the Family Home Program and ensures compliance with local, grant, contract , or licensure requirements. Manages staff in successful program implementation. MAJOR… more
- Prime Therapeutics (Providence, RI)
- …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
- Boys Town (Providence, RI)
- …on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider . We help our employees ... providing youth and families with therapeutic services. + Attends contract meetings and communicates the special qualities of Boys...into one of the largest national child and family care organizations in the country. With the addition of… more
- Elevance Health (Smithfield, RI)
- …and post payment auditing. + Correlates review findings with appropriate actions ( provider education, recovery of monies, cost avoidance, recommending sanctions ... and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and … more
- 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 ... is responsible for performing multifaceted financial analyses to assess manufacturer contract performance, plan performance and to develop rebate estimates related… more
- 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
