- Novo Nordisk Inc. (Minneapolis, MN)
- …industry meetings and develop relationships with industry associations for within Commercial, Medicaid and Medicare channels Create an effective network within ... Area Market Access accounts encompasses third party payers of Commercial, Medicaid and Medicare medical and prescription benefit plans. Customer channels and… more
- CVS Health (Lansing, MI)
- …large physician groups, and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the ... convenient and affordable. Position Summary In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high… more
- CVS Health (Phoenix, AZ)
- …of the National VBC Business Development team. You will work collaboratively across the Network and Medicaid organization to ensure speed to market and to ... Experience in Value Based Care financial models and value based care contracting /negotiations. + Experience in Medicaid Risk-based arrangements and Value-Based… more
- CVS Health (Houston, TX)
- …large physician groups, and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the ... achieve your career goals. Position Summary In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high… more
- CVS Health (Houston, TX)
- …Position Summary In this Texas Medicaid individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high level ... group/system providers.* Recruit providers as needed to ensure attainment of network expansion and adequacy targets. * Responsible for identifying and managing… more
- Humana (Salt Lake City, UT)
- …part of our caring community and help us put health first** The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, ... and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, ... and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where… more
- Providence (Renton, WA)
- …with senior leadership at the System and division levels, and with senior leaders in the Contracting Department, Population Health Division, and Operational ... by facilitating and maintaining strong working relationships between the Senior Contract Managers, Contract Managers, and other contracting...and serve as a thought leader with the Provider contracting team on issues related to network … more
- Hartford HealthCare (Wethersfield, CT)
- …is *yourmoment.* **Job:** **Administrative* **Organization:** **Hartford HealthCare Corp.* **Title:** * Senior Payer Analyst / Managed Care Contracting * ... here. We invite you to become part of Connecticut's most comprehensive healthcare network . The creation of the HHC System Support Office recognizes the work of… more
- Somatus (Mclean, VA)
- …development and execution of profitable agreements across Medicare Advantage, commercial insurance, Medicaid and Medicare FFS (direct contracting ). + Oversee the ... + And more! As the Vice President of Payer Contracting Strategy within the Business Development team, you will...including, but not limited to, Commercial, Medicare Advantage, and Medicaid plans, and oversee the development of new initiatives… more
- Humana (Columbus, OH)
- …cross-functional, collaborative organization which includes Provider Service Experience, Network Optimization, Clinical Services, Value-Based contracting , HEDIS ... more years of Provider Relations experience, Health care or Managed care, Provider Contracting , Network Management and Claims knowledge + Experienced in … more
- Humana (Columbus, OH)
- … network optimization reports, which are used to determine and correct network adequacy issues, and closely partnering with contracting teams to ensure ... network optimization reports, which are used to determine and correct network adequacy issues, and closely partnering with contracting teams to ensure… more
- Commonwealth Care Alliance (Boston, MA)
- …and Value Based Care,** the Facility Performance Incentive Programs. Work with network contracting and the finance department to develop, track contract ... and is responsible for managing and implementing key population health and network quality initiatives to achieve high performance on CCA's Population Health goals;… more
- Molina Healthcare (St. George, UT)
- …must live in Utah _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network ... the primary point of contact between Molina Healthcare and contracted provider network . They are responsible for network management including provider education,… more
- CVS Health (Topeka, KS)
- …coaching + Experience with coding + 3+ years provider facing activities/valued based contracting / network + Knowledge of HEDIS and Pay for Performance metrics, ... San Antonio, TX + Southern, IL Position Summary This Senior Analyst, Healthcare Quality Management will be a Quality...ICD-10 coding, Medicaid risk adjustment methodology, and common billing and common… more
- Molina Healthcare (Grand Rapids, MI)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... adequacy, and Joint Operating Committees. * Manages and reports network adequacy for Medicare, Marketplace, and Medicaid ...initiatives and regulations. * Manages and provides coaching to Network Contracting Staff. * Manages and evaluates… more
- Providence (Portland, OR)
- …trend analytics, forecasting, revenue and benefit expense budgeting, valuation, provider contracting analytics, and revenue liabilities and receivables. This role is ... and Pharmacy Trends + RAF (Risk Adjustment) Performance + Network Performance + Mentor managers and analyst and fosters...key analyses with appropriate level of detail analysis for senior leaders. + Manage vendor and consulting relationships. +… more
- Novo Nordisk (Minneapolis, MN)
- …Commercial, Medicaid and Medicare channels + Create an effective network within area Market Access, including associations, advisory boards, etc. + Develop ... Area Market Access accounts encompasses third party payers of Commercial, Medicaid and Medicare medical and prescription benefit plans. Customer channels and… more
- Molina Healthcare (Seattle, WA)
- …* Resolves complex provider issues that may cross departmental lines including Contracting , Finance, Quality, Operations, and involve Senior Leadership. * ... strategic network planning tools to drive Provider Relations and Contracting Strategy across the enterprise. * Facilitates strategic planning and documentation… more
- Molina Healthcare (Springfield, IL)
- …* Resolves complex provider issues that may cross departmental lines including Contracting , Finance, Quality, Operations, and involve Senior Leadership. * ... strategic network planning tools to drive Provider Relations and Contracting Strategy across the enterprise. * Facilitates strategic planning and documentation… more
