- CVS Health (Phoenix, AZ)
- …National VBC Business Development team. You will work collaboratively across the Network and Medicaid organization to ensure speed to market and to support ... processes and interdependences are identified and addressed. + Provides network development /expansion, provider relationships, and refinement activities in… more
- CVS Health (Lansing, MI)
- …as SME for less experienced team members and internal partners. + Provides network development , maintenance, and refinement activities and strategies in support ... cross market network management unit. + Assists with the design, development , management, and or implementation of strategic network configurations and… more
- CVS Health (Lansing, MI)
- …cost-saving initiatives and settlement activities. + Assists in the management of network development , maintenance, and refinement activities and strategies in ... methodologies. + Designs systems to recruit providers in support of network expansion and adequacy targets. + Integrates cross-functional collaboration to contribute… more
- Humana (Charleston, WV)
- …negotiates, and executes behavioral health provider contracts for Virginia Medicaid . The Provider Contracting Professional communicates contract terms, ... dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Use your… more
- CVS Health (Chicago, IL)
- …Contracting manages and oversees Value-based operation in compliance with our Network responsibilities as provided within the State Medicaid contractual ... value-based solutions to meet total cost and quality goals for our Medicaid businesses. + Responsible for collaborative development of alternative payment… more
- CVS Health (Houston, TX)
- …and quality. . Health Plan/Payer or Provider Systems experience Preferred Qualifications . Medicaid regulatory experience . Medicaid contracting & setup ... cost saving initiatives and/or settlement activities. Assists with the design, development , management, and or implementation of strategic network configurations… more
- CVS Health (Parsippany, NJ)
- …and quality. + Health Plan/Payer or Provider Systems experience Preferred Qualifications + Medicaid regulatory experience + Medicaid contracting & setup ... health care more personal, convenient and affordable. Position Summary The NJ Medicaid Lead Director, Network Management is accountable for designing conceptual… more
- CVS Health (Houston, TX)
- …as SME for less experienced team members and internal partners. * Provides network development , maintenance, and refinement activities and strategies in support ... cross market network management unit. * Assists with the design, development , management, and or implementation of strategic network configurations and… more
- CVS Health (Houston, TX)
- …as SME for less experienced team members and internal partners.* Provides network development , maintenance, and refinement activities and strategies in support ... care more personal, convenient and affordable. Position Summary In this Texas Medicaid individual contributor role the Network Management Senior Manager will… more
- CVS Health (Princeton, NJ)
- …must reside in New Jersey. The primary functions of the BH Senior Manager of Network Relations are: + Involvement in the development and maintenance of a ... + Provide provider education and develop and deliver provider training + Ensure network adequacy and appointment access, including development of network … more
- Providence (Renton, WA)
- …as a thought leader with the Provider contracting team on issues related to network development and value creation for the region. + Participate at a senior ... **Description** The Regional Vice President (RVP), Payer Contracting is the managed care leader at the...of managed services across Commercial, Exchange, Medicare Advantage and Medicaid product lines. The RVP works collaboratively in partnership… more
- Somatus (Mclean, VA)
- …across Medicare Advantage, commercial insurance, Medicaid and Medicare FFS (direct contracting ). + Oversee the development of short and long term cross-payer ... + And more! As the Vice President of Payer Contracting Strategy within the Business Development team,...including, but not limited to, Commercial, Medicare Advantage, and Medicaid plans, and oversee the development of… more
- CVS Health (Princeton, NJ)
- …to ensure service levels are meeting expectations. + Manages the development of agenda, validates materials, and facilitates external provider meetings. + ... and enlist assistance in problem resolution. + Conduct standard provider recruitment, contracting , or re- contracting activities and assist with more complex … more
- Humana (Bismarck, ND)
- …or equivalent + 5+ years of provider contracting including hospital contracting + 5+ years of progressive network management experience including hospital ... contracting and network administration in a healthcare company + Experienced in...dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities… more
- Humana (Oklahoma City, OK)
- …skills to make an impact** **Required Qualifications** + 8+ years of progressive network management experience including hospital contracting and network ... dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities As part of… more
- CVS Health (Irving, TX)
- …Provider Systems experience . Experience with value-based contracts. Preferred Qualifications . Medicaid regulatory experience . Medicaid contracting & setup ... and cost initiatives. Responsibilities include, but not limited to: . Manages Medicaid contract performance and drives the development and implementation of… more
- Humana (Lincoln, NE)
- …our caring community and help us put health first** The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider ... and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from… more
- Molina Healthcare (Richmond, KY)
- …manner.' **Knowledge/Skills/Abilities** * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of ... ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Educates and… more
- Highmark Health (Charleston, WV)
- …to: involved in hiring and termination decisions, coaching and development , rewards and recognition, performance management and staff productivity.Plan, organize, ... Develop and manage the design and implementation of provider network strategies and reimbursement methodologies, including alternative payment methodologies aimed… more
- CVS Health (Houston, TX)
- …be proficient in Word, Excel, and Microsoft Office. Preferred Qualifications + Medicaid contracting experience. + Strong critical thinking, problem resolution, ... helping you achieve your career goals. In this Texas Medicaid individual contributor role the contract negotiator: + Negotiates...as needed. May recruit providers as needed to ensure network adequacy and achievement of network expansion… more