- CVS Health (Atlanta, GA)
- …claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. **Required Qualifications** + Minimum 3+ ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- The Cigna Group (Atlanta, GA)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... + Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. + Creates "HCP" agreements… more
- CVS Health (Atlanta, GA)
- …demonstrates a broad, strategic approach to problem solving + 3+ years of Provider Contract Negotiation experience + 5+ years of Healthcare Industry experience ... role will create, lead and manage vendors to the contract SLAs, performance guarantees and provide insight...+ Demonstrated knowledge of medical cost drivers and managed care industry +… more
- Molina Healthcare (Atlanta, GA)
- …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
- Elevance Health (Atlanta, GA)
- …performance strongly preferred; Commercial and Medicaid experience a plus. + Experience driving provider cost of care and quality metric performance. Please ... a high-level technical resource in analyzing what is driving provider cost and quality trends for the...+ Researches and analyzes issues that may impact future provider program participation. + May provide mentorship,… more
- Molina Healthcare (Atlanta, GA)
- …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
- UMB Bank (Atlanta, GA)
- …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
- Cayuse Holdings (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Decatur, GA)
- … 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
- Option Care Health (Atlanta, GA)
- …alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly ... resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than...treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through… more
- Highmark Health (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …of Aetna's Dental Products and market position. The Senior Analyst negotiates provider contract language and compensation. This role is responsible to ... and implement cost saving strategies. + Collaborates cross-functionally to resolve provider issues with the utmost urgency. + Recruits providers as needed to… more
- CVS Health (Atlanta, GA)
- …+ 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
- Morehouse School Of Medicine (Atlanta, GA)
- …of the health professional and scientific workforce; * Address primary health care through programs in education, research and service; With emphasis on people ... department, division, institute or center) using knowledge of grant and contract management rules and regulations, technical expertise and analytical skills. Manages… more
- Black & Veatch (Atlanta, GA)
- …incidents and develop corrective actions.*Through the appropriate channels, review and provide input related to third-party vendor vetting, contract terms ... and field engineering. \#LI-KC1 #crane #cranemanager #construction The Crane Manager will provide support to Black & Veatch's Crane Manager regarding the management… more
- Bausch + Lomb (Atlanta, GA)
- …assistance and reimbursement support services, including but not limited to web-based provider programs and tools, and provide information on relevant ... through a reimbursement consulting agency. + Understanding of access and out-of-pocket cost considerations from a patient and provider perspective. + General… more
- Black & Veatch (Atlanta, GA)
- …and contract administration training. Preferred Skills: + Budget and Cost Control Skills + Solar construction experience + Industrial relations knowledge for ... issues related to drawings and information, schedule, quality, quantity tracking, cost reporting, and safety. + Monitors discipline solar construction productivity,… more
- Sedgwick Government Solutions (Atlanta, GA)
- …risks, facilitates continual improvement by leading improvement projects, and supports contract managers and the analytics team in preparing quality assurance ... opportunities for improvement, and present findings. + Understands each contract 's clinical quality assurance requirements and monitors compliance, in collaboration… more