- CVS Health (Baltimore, MD)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** The Medicaid Network Provider Relations Manager oversees our ... Provider Representatives + Partner with internal / external Network Provider Relations staff to...Qualifications** + Minimum of 5+ years of experience in Provider Relations ; experience in Medicaid … more
- Humana (Columbus, OH)
- …strategy and operationalizing the operational strategy related to provider relations , provider performance improvement, and network management. This ... expert on provider relations and provider engagement/performance improvement. + Provide oversight of...developing new processes. + 9+ years of experience in provider relations and network development… more
- Trinity Health (Columbus, OH)
- …in Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** Market Manager - Provider Relations and Network Development is responsible for the ... Provider Relations Managers. The Market Manager Provider Relations and Network Development...of protocols and procedures of Centers For Medicare and Medicaid . Services . Proven ability to work effectively… more
- Humana (Indianapolis, IN)
- …2+ years of health care or managed care experience working with providers (eg, provider relations , claims education). + Experience working with LTSS and HCBS ... ensure positive provider experience with Humana Healthy Horizons and promote network retention. Key roles and responsibilities: + Meets regularly, both in person… more
- WellSense (Boston, MA)
- …and experience **Experience:** + 4 or more year's progressively responsible experience in provider relations or network management required + Experience in ... Sr. Provider Relations Consultant- (MA residents)-$5000 sign...and promoting collaboration within Plan, as it relates to provider network maintenance. Manages territory inclusive of… more
- Molina Healthcare (Escondido, CA)
- …live in San Diego County _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for facility provider ... strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina… more
- Molina Healthcare (Port Arthur, TX)
- …live in Harris or Jefferson County _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...primary point of contact between Molina Healthcare and contracted provider network . In partnership with Director, manages… more
- Molina Healthcare (New York, NY)
- …Claims processing familiar with ( Medicaid /Medicare)** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...primary point of contact between Molina Healthcare and contracted provider network . They are responsible for … more
- Molina Healthcare (MI)
- …Remote and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... * Develops and deploys strategic network planning tools to drive Provider Relations and Contracting Strategy across the enterprise. * Facilitates strategic… more
- Molina Healthcare (Fresno, CA)
- …live in the Fresno, CA area _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...primary point of contact between Molina Healthcare and contracted provider network . They are responsible for … more
- Dignity Health (Bakersfield, CA)
- … Relations Supervisor will report directly to the Director of Physician Network Contracting. The Provider Relations Supervisor is responsible for ... and will lead the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO...overseeing the Provider Relations team within the department. This role involves managing… more
- Elevance Health (Tampa, FL)
- …include, local marketing and community relations , network development, provider partnerships, provider relations , medical management, case management ... **Director II Medicaid State Operations** Location: This position will work...direction of operational team who handles claims, configuration and provider payment resolution. + Leads and manages the local… more
- Prime Care Coordination (Webster, NY)
- Summary The Provider Relations Representative serves as the primary contact between providers and the organization. The position is responsible for servicing ... and servicing physicians, hospitals and ancillary providers within established guidelines. Provider Relations works closely with all other internal departments… more
- VNS Health (Manhattan, NY)
- …of government programs, including Medicare and Medicaid preferred Prior experience in Provider Relations preferred CAREERS AT VNS Health The future of care ... OverviewManages all aspects of provider relations within a specified geographic...Operations departments to administer demographic changes and renewals to provider contracts. + Monitors contract performance of network… more
- VNS Health (Manhattan, NY)
- …programs, including Medicare and Medicaid , preferred + Prior experience in Provider Relations , preferred + Reliable transportation to work sites, required ... OverviewManages all aspects of provider relations within a specified geographic...Operations departments to administer demographic changes and renewals to provider contracts. + Monitors contract performance of network… more
- VNS Health (Manhattan, NY)
- …Minimum one year of health care experience, required + Prior experience in Provider Relations and contracting, preferred + Knowledge of government programs, ... OverviewPlays a key role in supporting our VNS Health Upstate Network . Assists with building relationships with providers, assisting with operational tasks (such as… more
- Elevance Health (Miami, FL)
- …and conducts provider training including developing and distributing provider relations materials. + Responsible for providing quality, accessible ... and comprehensive service to the company's provider community. + Provide assistance regarding education,...refresher training. + Research issues that may impact future provider negotiations or jeopardize network retention. **Minimum… more
- Dignity Health (Camarillo, CA)
- …benefits include Paid Time Off and Sick Leave. **Responsibilities** As a Provider Relations Representative with the Dignity Health Management Services ... and articulate the processing of eligibility, authorizations and claims adjudication to the provider network + Are capable of continually re-prioritizing to meet… more
- CVS Health (Louisville, KY)
- …review, response, tracking, and routing of provider inquiries received via the provider relations department email box. + Works closely with both internal ... requirements of internal customers as it pertains to other provider network management areas. + Manage the...skills **Preferred Qualifications** + 1+ years' experience with KY Medicaid + Experience in Medical Terminology, CPT, ICD-9 codes,… more
- CVS Health (Austin, TX)
- …those in utilization management, care management, quality management), and colleagues within network and provider relations , to enhance the delivery ... Participation in clinical staff recruitment and ongoing performance improvement. - Provide strategic oversight and leadership for all behavioral health activities… more