- CVS Health (Frankfort, KY)
- …to build collaborative relationships with providers work cross-functionally to resolve complex provider contract issues + Demonstrated high proficiency with MS ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Molina Healthcare (Louisville, KY)
- …care , or other health care field. **Required Experience** 3 - 5 years provider contract negotiation experience in the health care field including, but ... QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider 's office,… more
- Molina Healthcare (Louisville, KY)
- …Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Utilizes standardized contract ... sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members. *...concert with Director. * Oversees the maintenance of all Provider and payer Contract Templates. Works with… more
- Humana (Frankfort, KY)
- …and help us put health first** Manage the end-to-end sourcing and contract management milestones for assigned cases, including issuing RFXs, evaluating proposals, ... to oversee sourcing activities, negotiate prices, manage payment terms, achieve Total Cost of Ownership (TCO) savings, counter cost increase proposals, generate… more
- UMB Bank (Frankfort, KY)
- …Risk, Compliance, Information Security, Finance, and Business Operations to ensure contract terms meet applicable standards and adequately protect UMB interests. You ... renewals, software license, maintenance, support, subscriptions, and/or other third-party contract commitments. Working for UMB is about collaborative spirit with… more
- Elevance Health (Louisville, KY)
- …The ** Provider Network Management Director** is responsible developing provider networks through contract negotiations, relationship development, and ... ** Provider Network Management Director** _Location: Alternate locations may...preferred. + Advanced knowledge in SPS, Contraxx, PLM2, and Cost of Care (CofC) strongly preferred. +… more
- Cayuse Holdings (Frankfort, KY)
- …offering a varied set of business lines, workforces, and credentials to provide solutions for government clients throughout the world. Our companies have years ... projects, and commitment to excellence. **The Work** The Cayuse Government Contract Pricing Specialist is a Pricing and Estimating professional who assesses… more
- Molina Healthcare (Louisville, KY)
- …with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region. + Maintains contractual relationships with ... systems, hospitals and physician groups that result in high quality, cost effective and marketable providers. **KNOWLEDGE/SKILLS/ABILITIES** + In conjunction with … more
- ChenMed (Louisville, KY)
- … cost trends, market dynamics, cost drivers. + Conduct contract negotiations with provider groups as needed to enhance availability, accessibility, ... these relationships to optimize access, clinical outcomes, and total cost of care for ChenMed patients. The...review meetings to report on referral operations and medical cost performance data and provide progress reporting… more
- Highmark Health (Frankfort, KY)
- …years Experience working in an Actuarial Science capacity + 2 years Understanding of provider contract documents and overall contract management process + 1 ... 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
- Sedgwick (Frankfort, KY)
- …Surety Claims Advisor **PRIMARY PURPOSE** **:** To analyze complex or technically difficult contract surety bond claims; to provide resolution of highly complex ... Taking care of people is at the heart of...RESPONSIBILITIES** + Analyzes and processes complex or technically difficult contract surety (pay and performance) claims by investigating and… more
- CVS Health (Frankfort, KY)
- …+ Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/Claims Research Medicaid team. Extensive claims research ... framework to make financial decisions to resolve provider issues. Explain provider 's rights and responsibilities in accordance with contract . + Process claim… more
- Humana (Frankfort, KY)
- …help us put health first** The Value-Based Programs Lead supports successful value-based provider relationships with a focus on improving the provider experience ... are met and sustained over the life of a contract . + Bridges the gap of Value-based program pilots...**Required Qualifications** + 5+ years of Healthcare or Managed Care experience + 5+ years of Value-based care… more
- CVS Health (Frankfort, KY)
- … drafting; compliance and regulatory analysis; special investigations; provider relations; customer service or audit experience. **Preferred Qualifications** ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Elevance Health (Louisville, KY)
- …with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. + Manages non-clinical needs of members ... (BH)/LTSS needs, as required by applicable state law and contract , and federal requirements. **How you will make an...and Experiences:** + Experience working with older adults in care management, provider or other capacity, highly… more
- Sedgwick (Frankfort, KY)
- 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 ... staff for Auto liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide … more
- Black & Veatch (Louisville, KY)
- …develop and implement the proposal win strategy on key opportunities. + Participate in cost review and influences team to provide responses with competitive ... a team of proposal managers with responsibilities from pursuit assignment to contract signing. + Manage team workload and proposal assignment activities. +… more
- Prime Therapeutics (Frankfort, KY)
- …solutions to Prime's clients to ensure Prime is delivering the highest quality and lowest cost of care to its members. The Trade Client Relations Senior Director ... of rebate guarantees, pharmaceutical manufacturer rebate agreements and drug trends; provide proactive strategic and cost saving consultation + Provides… more
- Sedgwick (Frankfort, KY)
- 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
- Prime Therapeutics (Frankfort, KY)
- …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 ... area of Prime Therapeutics. This position is also responsible for assisting contract negotiators and working with other internal departments regarding the financial… more