- CVS Health (Trenton, NJ)
- …Managed Care Network Value Based Contacting experience with 2-3 years Medicaid Network experience + Must have Microsoft Office experience with intermediate ... make health care more personal, convenient and affordable. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our… more
- CVS Health (San Antonio, TX)
- …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 (Raleigh, NC)
- …and quality. + Health Plan/Payer or Provider Systems experience **Preferred Qualifications** + Medicaid regulatory experience + Medicaid contracting & setup ... care more personal, convenient and affordable. **Position Summary** The Lead Director, Network Management - Medicaid /North Carolina is accountable for designing… more
- CVS Health (Harrisburg, PA)
- …track record negotiating contracts with large or complex provider systems. + Medicaid Network Management/LTSS Contracting experience. + Strong communication, ... for assisting in the reviewing, building and auditing complex contracts and network data, support recruitment efforts, and collaborate on negotiations as needed. +… more
- CVS Health (Princeton, 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… more
- The Cigna Group (Scottsdale, AZ)
- …Medicaid and or Individual and Family Plans. + Skills in provider network development and management, value-based care contract execution including risk ... projects related but not limited to implementation of strategic initiatives regarding Network Solutions and Innovative Contracting to enhance provider supply and… more
- CVS Health (King Of Prussia, PA)
- …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 (Green Bay, WI)
- …dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Modern Hire** ... our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other… more
- CVS Health (Dallas, TX)
- …+ Medicaid product pricing + Health Plan Operations + Provider contracting and reimbursement methodologies + Medicaid , Medicare or Commercial health ... more personal, convenient and affordable. **Position Summary** The Executive Director, CFO Texas Medicaid Market role will function as the CFO for the Texas … more
- Prime Therapeutics (Columbus, OH)
- …drives every decision we make. **Job Posting Title** Contract Manager - NC Medicaid **Job Description Summary** Responsible for the implementation and support of all ... with all areas of the Prime Therapeutics organization to coordinate network management and network administration responsibilities and facilitates resolution… more
- Prime Therapeutics (Columbus, OH)
- …we make. **Job Posting Title** Contract Manager Vendor Performance - LA Medicaid - Remote **Job Description Summary** Responsible for the implementation and support ... with all areas of the Prime Therapeutics organization to coordinate network management and network administration responsibilities and facilitates resolution… more
- CVS Health (Richmond, VA)
- …during the credentialing or data management processes. - Responds to network or provider/producer inquiries, including contracting and credentialing policy, ... - Maintains high production and quality factors. - Participates in development of credentialing processes and workflows. - Identifies improvement opportunities and… more
- Prime Therapeutics (Columbus, OH)
- …strategies and compliant with Network Management policies + Create and manage network contracting campaigns with network vendor; analyze information and ... or Network Client Services initiatives + Perform network development , network analysis and...years of managed care experience in medical or pharmacy network contracting + Must be eligible to… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager II Job Category: Provider Relations Department: Provider Network Management Location: Los Angeles, CA, US, 90017 Position Type: ... to support the safety net required to achieve that purpose. Job Summary The Provider Network Account Manager II is responsible for all aspects of the LA Care (LAC)… more
- Henry Ford Health System (Troy, MI)
- …for provider strategic relationships and direction of key operations related to network development , physician/hospital contracting , APM contracts, provider ... The Director, Provider Network Management (PNM) with Health Alliance Plan (HAP),...Health Alliance Plan (HAP), will be responsible for provider contracting and management of provider relations for assigned accounts… more
- Wellpath (Nashville, TN)
- …training, education, and point of care support. **How you make a difference** The Network Development Manager is responsible for the strategic development , ... large or complex national providers. + Experience with provider contracts, contracting options, contract terms, reimbursement structure (Medicare/ Medicaid ) as… more
- CVS Health (Hartford, CT)
- …close gaps and maximize the provider network . Lead a team of Network Development Auditors responsible for reviewing and assessing provider contracting ... of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. Manages provider contracting intake… more
- Elevance Health (Olathe, KS)
- …trainings, identifying gaps and ad-hoc training needs + Works collaboratively with Network Support, Contracting , and Credentialing associates to ensure LTSS ... **Anticipated End Date:** 2024-09-30 **Position Title:** LTSS Network Education Representative Sr. **Job Description:** **LTSS Network Education Representative… more
- Elevance Health (Chicago, IL)
- …and terminations). **Job Level:** Staff/Regional VP **Workshift:** **Job Family:** PND > Network Contracting Please be advised that Elevance Health only accepts ... experience with contracting for all 3 lines of business (Commercial, Medicaid and Medicare) highly preferred. + Value Based Contracting experience within… more
- WellSense (Boston, MA)
- …improvement of departmental policies, procedures, workflows, and tools as they relate to network development and provider contracting ; + Represents the ... and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical...Contracting , the Senior Contract Manager assists in the development of network -wide strategies to improve efficiencies… more