- The Cigna Group (Morris Plains, NJ)
- **POSITION SUMMARY:** The Network Advisor is responsible for initiating maintenance and strategy solutions for all Centene Lines of Business. Responsible for the ... planning, internal coordination, maintenance, and communication of client Network activities and performance for Line of Business initiatives while maintaining key… more
- LA Care Health Plan (Los Angeles, CA)
- …provided to LA Care Medi-Cal members. This serves to help maintain a quality and solvent provider network and avert provider network disruptions due to ... Compliance Advisor II Job Category: Administrative, HR, Business Professionals...public agency created by the state of California to provide health coverage to low-income Los Angeles County residents.… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …campaign, new designs or benefit changes. + Works in a concerted manner with Provider Relations / Network Development and communicates to them any providers that ... Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY 10304,...we should attempt to recruit. + Ensures Provider Relations/ Network Development Representatives are abreast on… more
- Dignity Health (Prescott, AZ)
- …+ Provide compliance element for Centers for Medicare and Medicaid Services (CMS)Conditions of Participation (COP) by performing secondary medical necessity ... with facility utilization initiatives (ie leverage the leadership influence of Physician Advisor by mobilizing other physicians and staff). Provide education to… more
- Centers Plan for Healthy Living (Bronx, NY)
- …campaign, new designs or benefit changes. + Works in a concerted manner with Provider Relations / Network Development and communicates to them any providers that ... Licensed Benefits Advisor (Bilingual Preferred - Field Based) Bronx, NY,...we should attempt to recruit. + Ensures Provider Relations/ Network Development Representatives are abreast on… more
- Conviva (North Miami Beach, FL)
- …our caring community and help us put health first** The Patient Service Advisor is an embedded growth and retention associate responsible for executing initiatives ... and providing a personalized care journey. The Patient Service Advisor plays a key role in ensuring success of...with strong communication skills and a proven ability to provide excellent customer service, enhance consumer engagement, and foster… more
- General Dynamics Information Technology (Fairfax, VA)
- …services and non-emergency services provided by out-of- network providers at in- network facilities and provide numerous patient protections, including the ... opportunity. And our work depends on a **Health Policy Advisor ** joining our team to remotely support the Centers...team to remotely support the Centers for Medicare and Medicaid Services (CMS) Marketplace Assister Technical Support (MATS) Logical… more
- Elevance Health (Olathe, KS)
- **Business Change Advisor , Kansas Claims and Operations** **Location:** Topeka KS, or Olathe, KS This position will work a hybrid model (remote and office). The ... of one of our Kansas Elevance Health PulsePoint locations. The **Business Change Advisor for Kansas Claims and Operations** will be responsible for assisting the… more
- Elevance Health (Richmond, VA)
- The **Business Change Advisor (Test Analyst)** is responsible for assisting the senior leadership team within the business unit and the organization in bridging the ... will make an impact:** + Helps build and support the company's change network . + Communicates information from a variety of sources through newsletters, dashboards… more
- AmeriHealth Caritas (Newark, DE)
- …their providers: + Identifying and implementing evidence-based practice guidelines throughout the provider network . + Overseeing the quality of clinical care for ... network and non- network providers. + Engaging the provider network in Continuous Quality Improvement through the diffusion of practice standards, and… more
- Bassett Healthcare (Cooperstown, NY)
- … Network Finance Division. The VP, Financial Operations serves as a leader, advisor , and educator, on financial matters for Network Department leaders and ... office reporting system for Medicare Cost reporting. Identify unique funding levels in Medicaid and Medicare based on rural provider status. Review information… more
- LA Care Health Plan (Los Angeles, CA)
- …all lines of business. Identification of potential areas of improvement within the provider network . Identify and initiate referrals for appropriate members to ... Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's… more
- University of Colorado (Aurora, CO)
- …NPI number by date of hire + Must be willing and able to obtain valid Colorado Medicaid Provider number within 30 days of hire date + Must be willing and able ... Denver, CO 80236** **Position #00647543 - Requisition #32571** **Job Summary:** **Health care provider positions at SHS, such as this one, qualify for federal and… more
- Magellan Health Services (Albuquerque, NM)
- …Works closely with the network management team on an integrated clinical- network approach which may include provider relationships. Visits providers and ... the clinical vision for the health plan(s) for all lines of business ( Medicaid , Medicare and Commercial) and implements and manages programs to support this vision.… more
- Catholic Health Initiatives (Bryan, TX)
- …coordination. The social worker has the ability to carry the role of advisor , therapist, administrator and clinician. CHI St. Joseph Health Cancer Center - College ... is a leader in critical care and the largest provider of cardiovascular care in the region. As an...healthcare system CHI St. Joseph Health includes a comprehensive network of over 100 employed providers including primary care… more
- Ascension Health (Murfreesboro, TN)
- …education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics._ **Responsibilities** Provide distributive ... providing necessaryinformation. Communicate with external resources such as retail pharmacies, provider officers, and data exchanges. + Identify and assist with… more
- Cardinal Health (Columbus, OH)
- …care contracts. This includes coordination of commercial, Medicare Advantage, Managed Medicaid and other third-party managed care contracts and payer relation ... to the Managed Care environment. They will be a seasoned leader and advisor , with proven experience supporting physicians in oncology to identify and realize payer… more
- State of Georgia (Fulton County, GA)
- …Division. The Assistant Attorney General serves as the attorney and legal advisor for state agencies, departments, authorities and the Governor; specific duties ... fraud, securities fraud, AND fraud and abuse by providers in the Georgia Medicaid program. Duties & Responsibilities: + Provides legal advice to state entities on… more