- The Cigna Group (Bloomfield, CT)
- The ** Provider Network Contractor ** serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior ... and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide guidance or expertise to… more
- The Cigna Group (Bloomfield, CT)
- …Medicare Advantage position** WORK LOCATION: REMOTE position The **National Ancillary Medicare Advantage (MA) Provider Contracting Senior Advisor** is a ... national contracts including clinical programs, MA Supplemental benefits, and direct provider agreements. This role operates at a strategic level engaging **directly… more
- Health Advocates Network (Danville, PA)
- …advanced nursing practices. General Supervision is received from a facility administrator. CONTRACTOR RESPONSIBILITIES Each Contractor must provide any ... (CNRP)- Short-Term **Pay Rate:** $48 / hour *1099 Independent Contractor Minimum Qualifications Certain certification as Registered Nurse Practitioner by… more
- MetroLink (Los Angeles, CA)
- …are not to be interpreted as an exhaustive list of responsibilities. + Provide oversight for SCRRA's inspections, condition ratings, state of good repair, asset ... 237 Bridge Engineer, which includes, but not limited to, provide oversight of the QC/QA program for structures in...Class 1 Freight Railroad or as a consultant or contractor working on long term assignments involving Commuter/Passenger or… more
- MetroLink (Los Angeles, CA)
- …supervise full-time or part-time staff and may be called on to provide mentorship to lower classifications. ESSENTIAL DUTIES AND RESPONSIBILITIES The duties listed ... reports; and presenting to the Board of Directors. + Provide answers to contractors' questions regarding the bid process...criteria and work with Project Managers for monitoring their contractor 's performance. + Negotiate and process a high volume… more
- CareOregon (Portland, OR)
- …plan in support of CCOs, Medicare , contract negotiations and/or other provider expansion activities. + Provide medical support for Care Management ... population health initiatives for the organization including clinical quality in the provider network . Essential Responsibilities + In partnership with the CCO… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... responsible for general gynecological care of women, but also provide care related to pregnancy and the reproductive system....delivery, and postpartum care. The role of the gynecological provider at Kelsey Seybold spans the adult lifetime of… more
- Kelsey-Seybold Clinic (Webster, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... for general gynecological medical care for women, but also provide care related to pregnancy and the reproductive system....and postpartum care. The role of the gynecological APC provider at Kelsey Seybold spans the adult lifetime of… more
- Kelsey-Seybold Clinic (Houston, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... value-based commercial health plans. KelseyCare Advantage (https://www.kelseycareadvantage.com/) , a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated… more
- Immigration and Customs Enforcement (IN)
- …focus on governance of the referral process for off-site medical services, a provider network , and claims adjudication and utilization management. HPMU staff ... billing and coding principles, medical claim resolution processes within HPMU, and provider recruitment initiation as applicable. Duties include day to day managing,… more
- Kelsey-Seybold Clinic (Houston, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... Kelsey-Seybold is actively seeking a Radiology Practitioner Assistant. The provider extender will work in a clinic setting supporting the Radiology Department.… more
- Humana (Fort Bragg, NC)
- …our nation's military? Humana Government Business is a top 10 Department of Defense contractor , with a long history in the TRICARE business and has recently been ... the TCL is responsible for ensuring MTF, beneficiary, and provider understanding of the TRICARE health plan and how...the Health System Manager/Consultant in managing the local TRICARE network in designated Prime Service Areas (PSAs) and Non-Prime… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... with the desire to focus on Medical Dermatology. The provider extender will work in a clinic setting supporting...physician in an effort to more effectively and efficiently provide optimum care to the Kelsey-Seybold patient population. This… more
- Kelsey-Seybold Clinic (The Woodlands, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... **Job Summary:** Kelsey-Seybold Clinic's Pediatricians provide care from birth to early adulthood and...work on an "as needed" basis + Attend New Provider Orientation + Follow all KSC policies and procedures… more
- Kelsey-Seybold Clinic (Pasadena, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... for department EPIC Optimization requests and implementations from the clinical provider perspective + Substitutes for other department extenders as needed, which… more
- Kelsey-Seybold Clinic (Porter, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... in Houston. Qualified candidate must have a valid Texas provider license. Duties will be providing supporting GI physicians...rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive… more
- Kelsey-Seybold Clinic (The Woodlands, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... Exams. The physician would serve as a Primary Care Provider for Executive Health and Premier Prevention patients for...rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive… more
- Apex Health Solutions (Houston, TX)
- …such as utilization counters and their relation to eligibility; good understanding of provider network arrangements and their relation to eligibility Ability to ... initial points of contact with our client organization membership and shall provide initial onboarding through a disciplined flow of call scripting. Individuals… more
- Kelsey-Seybold Clinic (Houston, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... and clinical policies and procedures **Essential Duties and Responsibilities:** + Provide consultation services in palliative care + Provide education/guidance… more
- Kelsey-Seybold Clinic (Sugar Land, TX)
- …in- network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold ... otolaryngologists as ear, nose, and throat (ENT) doctors. They provide both medical and surgical care. The ideal candidate...rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive… more