- Novo Nordisk Inc. (Plainsboro, NJ)
- …and interacts extensively with other functions within and across Novo Nordisk. Provide key HCP Relationship strategy input into the brand, sales, and compliance ... They will regularly interface with their direct report, the Peer-to-Peer Relations Specialist . This role will regularly collaborate with various parts of the… more
- Healthfirst (NY)
- …point of contact for all plan related issues including marketing, enrollment, contracting , billing and reimbursement. + Responsible for the resolution of all issues, ... including those identified by the provider , and those identified internally that have an impact...issue logs, conference calls, etc. + Responsible for the provider recruitment process. Identify gaps, complete paperwork, etc. +… more
- PeaceHealth (Vancouver, WA)
- **Description** **PeaceHealth is seeking a remote Physician Contracting Specialist . This role requires the incumbent to reside in OR, WA, AK or TX by date of ... a Full Time, 1.00 FTE, Day position.** The Physician Contracting Specialist serves as the primary liaison...PeaceHealth networks. + Serves as the primary resource for network leadership to answer questions, provide research,… more
- WellSense (Boston, MA)
- Contracting Specialist WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, ... works for our members, no matter their circumstances. **Job Summary:** Supports the Provider Network Management Department by assuming the pivotal role of the… more
- Medical Mutual of Ohio (OH)
- …plan for a provider 's non-compliance, as well as training of the Provider Contracting staff, Provider Payments - quarterly MA Health Professional ... the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million...policies and procedures. Provides onboarding and annual training to provider network management staff. . Contributes to… more
- Molina Healthcare (Florence, KY)
- …and must live in the United States _** **JOB DESCRIPTION** **Job Summary** Provider Network Administration is responsible for the accurate and timely validation ... requirements of internal customers as it pertains to other provider network management areas, such as ...Provider Services/ Provider Inquiry Research & Resolution, Provider Contracting / Provider Relationship Management). +… more
- Centene Corporation (Phoenix, AZ)
- …+ Receive and effectively respond to external provider related issues + Provide education on health plan's innovative contracting strategies + Initiate data ... oversee testing and completion of change requests for the network + Investigate, resolve and communicate provider ...in related field or equivalent experience. 0-2 years of provider relations or contracting experience. Knowledge of… more
- Medical Mutual of Ohio (OH)
- …Provider Contract Support Specialist Under general supervision, supports provider contracting department by developing and maintaining familiarity with ... the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million...Contract Support Specialist Under limited supervision, supports provider contracting department (typically more senior level… more
- Medical Mutual of Ohio (OH)
- …on-going sanction monitoring issues.Gathers and summarizes information for Credentialing Committee or Provider Contracting and responds to questions as needed. + ... and summarizes complex issues found in review to Credentialing Committee or Provider Contracting and responds to questions. May attend Committee meetings… more
- Molina Healthcare (CA)
- …and must live in California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... recruiting and negotiating with providers. * Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's… more
- Molina Healthcare (ID)
- …Remote and must live in Idaho _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations...sent as directed by management. * Formats and distributes Provider network resources (eg electronic specialist… more
- Marshfield Clinic (Marshfield, WI)
- …cooperation with the Contracting Manager - Marshfield Clinic Health System Provider Network and other department and organization colleagues to deliver ... solutions to identified issues. **Preferred/Optional:** Experience in payor and/or provider contracting , including professional services, facility, lab,… more
- City of New York (New York, NY)
- Job Description Administrative Contract Specialist - NON-MGRL Former M1/M2-1009A - OPEN TO PERMANENT INCUMBENTS IN THE TITLE OF ADMINISTRATIVE CONTRACT SPECIALIST ... MANAGER. Division/Program Summary Description: The Bureau of the Agency Chief Contracting Officer within the Division of Finance is primarily tasked with… more
- Sharp HealthCare (San Diego, CA)
- …to identify potential providers for the Sharp Health Plan provider network .Works closely with utilization management and contracting teams to ensure ... virtually, and conducts physician, hospital and/or ancillary meetings, as necessary.Ensures provider network meets all regulatory and accreditation requirements… more
- Integrative Emergency Services (Dallas, TX)
- Integrative Emergency Services, LLC ("IES") is looking for a Provider Enrollment Specialist to support the division in facilitating the enrollment (submitting of ... and individual providers with the various government and insurance healthcare payors, network managed care contracting plans, and third-party billing entities… more
- Highmark Health (Columbus, OH)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Coordinates and facilitates the enrollment of Allegheny Clinic professional ... providers with various payers for professional services reimbursement. Reviews provider credentialing and/or recredentialing data for accuracy based on licensing… more
- BayCare Health System (Tampa, FL)
- …to 4:00 PM (may vary) + **Days:** Monday through Friday The **Credentialing and Provider Enrollment Specialist ** is a full-time remote position. This team member ... issues by coordinating with the plans, the CBO and the Managed Care contracting department. **Why BayCare?** Our network consists of 16 community-based… more
- Trinity Health (Boise, ID)
- …the work necessary for resolution of questions regarding claims, fee schedules, network contracting , provider credentials verification, payer enrollment, and ... guidelines. Responsible for issuing new network Participation Agreements for all network provider types. Assists Contract Specialist in verifying… more
- Magellan Health Services (Albuquerque, NM)
- …organizational providers to meet network adequacy standards and assure quality network . + Conducts and coordinates contracting and amendment initiatives. + ... Minimum of 1 year experience in related position/field. General Job Information Title Network Management Specialist Grade 21 Work Experience - Required … more
- Guardian Life (Boston, MA)
- **2025 Guardian Summer Intern, Dental Network Support Specialist ** Our 2025 Internship Program is a paid 10-week learning experience where you will be immersed ... products and other internal systems. + Interact effectively with other recruiters, provider relations representatives, the DSO support team, network business… more
