- CareOregon (Portland, OR)
- Job Title Network Access and Adequacy Program Manager Requisition # 24774 Exemption Status Exempt Management Level n/a Direct Reports n/a Manager Title ... downtown Portland office 1-2 times per week. Job Summary The Network Access and Adequacy Program Manager oversees CareOregon's Network Access and… more
- LA Care Health Plan (Los Angeles, CA)
- …provider issues. The Account Manager III is responsible for monitoring and managing network adequacy by assuring appropriate access to services throughout ... right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's...standard provider dataset is complete, accurate, and current. Provides network adequacy analysis and data to the… more
- LA Care Health Plan (Los Angeles, CA)
- …provider issues. The Account Manager II is responsible for monitoring and managing network adequacy by assuring appropriate access to services throughout ... right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's...standard provider dataset is complete, accurate, and current. Provides network adequacy analysis and data to the… more
- AmeriHealth Caritas (Youngstown, OH)
- …market strategy. + Recruit providers as needed to ensure the realization of network adequacy targets. + Initiates and maintains effective communication channels ... and works to resolve provider issues. Responsible for monitoring and managing provider network by assuring appropriate access to services throughout the Plan's… more
- General Dynamics Information Technology (Macdill AFB, FL)
- …Required:** None **Job Family:** Systems Administration **Skills:** Network Architecture, Network Infrastructures, Network Operations,Troubleshooting ... years of related experience **US Citizenship Required:** Yes **Job Description:** ** Network Infrastructure Technician - Tier 2** **Job Description:** GDIT is looking… more
- Molina Healthcare (Atlanta, GA)
- …Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, ... are the primary point of contact between Molina Healthcare and contracted provider network . They are responsible for the provider training, network management… more
- Cedars-Sinai (CA)
- …all other aspects of Managed Care, quality & efficiency measures, Star ratings, access , physician network integrity, physician network performance, patient ... **Job Description** The Program Manager is responsible for supporting all facets...and departments within Cedars-Sinai Medical Center, the Cedars-Sinai Medical Network , Marina del Rey Hospital, and other Cedars-Sinai Health… more
- Fresenius Medical Center (Ponce, PR)
- …regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). + Ensures ... strength in the North American market and extensive global network provide our employees with the best of both...procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues… more
- Fresenius Medical Center (Philadelphia, PA)
- …regarding adequacy measures where applicable - Online Clearance Monitoring (OLC) Adequacy Monitoring Program (AMP) Urea Kinetic Modeling (UKM). + Ensures ... strength in the North American market and extensive global network provide our employees with the best of both...procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues… more
- Mayo Clinic (Austin, MN)
- …or reimbursement account for flexible coverage. + Vision: Affordable plan with national network . + Pre-Tax Savings: HSA and FSAs for eligible expenses. + Retirement: ... embark on a life-changing journey? Join the Nurse Residency Program at the Mayo Clinic Health System. This is...your future. As a Mayo Clinic employee, you'll have access to a wide range of career opportunities, including… more
- WellSense (Boston, MA)
- …all critical functions necessary to assess, develop, maintain and/or improve provider network adequacy and performance. Our Investment in You: . Full-time ... Gathers and analyzes data and other relevant intelligence in assessing provider network adequacy against required standards and business expectations; .… more
- Molina Healthcare (Long Beach, CA)
- …Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, ... the primary point of contact between Molina Healthcare and contracted provider network . In partnership with Director, manages and coordinates the Provider Services… more
- Cedars-Sinai (Los Angeles, CA)
- …, and collaborating with Network Contracting to ensure clear pathways and network adequacy for referral to outside mental health resources. The MH Medical ... psychiatrist who oversees mental health services in the Medical Network and provides support related to the mental health...mental health care that cannot be managed by this program . For reference, the collaborative care model consists of… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …against non-compliance, waste, fraud, and abuse by appraising the soundness, adequacy , and application of accounting, financial, and other operating controls; ... of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective, and efficient services and...require completion of additional referral questions (RQs). You can access these RQs via an email that will be… more
- CVS Health (Tallahassee, FL)
- …with others at all levels + Knowledge of Medicaid Regulatory Standards for Network Access , Credentialing, Claims Processing, Provider Appeals & Disputes and ... + Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Henry Ford Health System (Detroit, MI)
- …and competitive landscape to identify new business opportunities and support network . development/ adequacy , provider diversity, expansion of payor contracts ... GENERAL SUMMARY: Reports to the Director of Network Growth & Partnerships (Clinically Integrated Network...achieve growth targets. . Works closely with Provider Affairs, Program Performance, and other teams to coordinate provider recruitment… more
- Fresenius Medical Center (North Myrtle Beach, SC)
- …Leadership Team. Our strength in the North American market and extensive global network provide our employees with the best of both worlds-the friendliness of a ... + Competitive compensation and exceptional benefits. + Outstanding tuition reimbursement program . + Recognized among Fortune's World's Most Admired Companies- in… more
- CVS Health (Sacramento, CA)
- …+ Oversee and manage all network -related filings in DMHC filings, including network adequacy , timely access , and new product filings. This includes ... to work West Coast hours This role will support network filings for the two regulators in California: California...proficiency with data analysis and reporting tools including Microsoft Access , Microsoft Excel, Microsoft BI, SQL, and Tableau. +… more
- Northrop Grumman (Melbourne, FL)
- …By joining in our shared mission, we will support yours of expanding your personal network and developing skills, whether you are new to the field or an industry ... be limited to the following: + Maintaining operations of multi-user Linux network services. + Providing technical support for Linux systems and associated networks.… more
- PruittHealth (Atlanta, GA)
- …region; support continued regional network development activities necessary to meet network adequacy requirements. 4. Meet with the member and/or their ... and our skilled nursing facility partners. They help resolve member complaints, provider access issues, claims concerns, conduct network outreach, help ensure … more