- CVS Health (Montpelier, VT)
- …complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals. ... outcomes, all while supporting cost-saving initiatives and the growth of the provider network . **Required Qualifications** + Negotiates, executes, and conducts… more
- The Cigna Group (Cleveland, OH)
- …Providers. Must reside in the Cleveland or Independence, OH area.** The **Director, Provider Contracting Network Management** serves as an integral member ... Contracting Team and reports to the Provider Contracting Senior Manager. This...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- The Cigna Group (San Diego, CA)
- …an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager or VP of Contracting . This role ... strategic direction and management of the day to day contracting and network management activities for a...and Marketing and Service. + Manages strategic positioning for provider contracting , develops networks and identifies opportunities… more
- CareFirst (Baltimore, MD)
- … provider networks. Performs duties to coordinate and support all types of provider contracting in accordance with guidelines in order to maintain and enhance ... the provider network and to meet accessibility, quality...department. + Develop business cases and present findings to Senior Management to support reimbursement and contracting … more
- VNS Health (Manhattan, NY)
- … capacity and regulatory requirements.* Provides leadership and oversight for assigned provider network contracting , including negotiation of contracts done ... Health's Health Plan Physician, Ancillary, Hospital provider networks. Includes contracting , rate setting, monitoring for and maintaining network adequacy of… more
- City of New York (New York, NY)
- …development programs across the City. The Workforce Connect division is seeking a Senior Contracting and Fiscal Operations Analyst to join the Workforce Connect ... of Youth and Community Development (DYCD) invests in a network of community-based organizations and programs to alleviate the...programs to alleviate the effects of poverty and to provide opportunities for New Yorkers and communities to flourish.… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …a related field required. + 7-10 years of experience in managed care contracting , network management, or payer relations within an integrated healthcare setting ... + GENERAL SUMMARY + The Leader, Managed Care Contracting , is responsible for all aspects of payer...is responsible for all aspects of payer contract negotiations, network management, and strategic partnerships for an integrated pediatric… more
- Point32Health (Canton, MA)
- …submissions, RFP/UDS submissions (as well as finding improvements) and ad hoc requests. The Senior Network & Provider Analytics Analyst may also serve as ... Summary** Working under the direction of the Director or Senior Manager, the Senior Analyst will be...analysis of new reimbursement strategies and financial analytics supporting provider contracting in the Point32Health network… more
- Molina Healthcare (Troy, MI)
- **_ Remote and must live in Michigan _** **JOB DESCRIPTION** **Job Summary** Provider Network Administration is responsible for the accurate and timely ... 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
- Humana (Columbus, OH)
- …translated into letters and contract templates, developing internal and provider facing educational materials, managing non-standard language and financial terms ... Medicaid VBP contract development, operational set-up, and execution. The Value Based Contracting Lead requires in-depth understanding of VBP and the contracting … more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Knowledge of common/standard Value Based Contracting components and principles. ** Senior Provider Network Performance Analyst** **Education and ... contracting regions with quality, utilization, and cost analysis. ** Provider Network Performance Analyst I** + Gathers...junior level Analyst. + Performs other duties as assigned. ** Senior Provider Network Performance Analyst**… more
- UPMC (Pittsburgh, PA)
- …Experience following fields: value-based contracting , pricing, reserving, trend/health economics, provider network analysis, risk adjustment, etc + FSA or ... exciting opportunity for an Actuary Lead on their rockstar Value-Based Contracting Team!** This position applies knowledge of mathematics, probability, and… more
- City of New York (New York, NY)
- …MANAGER. Division/Program Summary Description: The Bureau of the Agency Chief Contracting Officer within the Division of Finance is primarily tasked with ... policies. Position Summary: Under direct supervision of a Deputy Agency Chief Contracting Officer, the selected candidate will utilize varying degrees of managerial… more
- Molina Healthcare (Warren, MI)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... information on all claims and provider databases. Responsible for contracting /re- contracting of standard deals, maintaining network adequacy, issue… more
- The Cigna Group (Scottsdale, AZ)
- …Compliance, Sales and Marketing and Service. + Manages strategic positioning for provider contracting , develops networks and identifies and acts upon ... Providers AND several days work at Home_** The **AVP, Provider Contract Network Management** serves as an...strategic direction and is accountable for the management of contracting and network management activities for multiple… more
- Elevance Health (Atlanta, GA)
- ** Provider Network Manager Senior **...degree and a minimum of 5 years' experience in contracting , provider relations, provider servicing; ... of one of our Elevance Health PulsePoint locations. The ** Provider Network Manager Senior ** will...development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the… more
- CVS Health (Sacramento, CA)
- …+ This is an individual contributor role **Required Qualifications** + 7+ years of network contracting /management experience + Ability to travel as needed (up to ... Matter Expert support for questions related to recruitment initiatives, contracting , provider issues/resolutions, related systems and information contained… more
- Elevance Health (Indianapolis, IN)
- …provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you will make an impact:** + Focuses ... ** Provider Contract Cost of Care Consultant Senior...improving the quality of care, and increasing member and provider network satisfaction. + Provides expert advice,… more
- Molina Healthcare (Long Beach, CA)
- …in Los Angeles County _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, ... staff are the primary point of contact between Molina Healthcare and contracted provider network . They are responsible for network management including… more
- Elevance Health (Mason, OH)
- … Senior ** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the ... ** Provider Contract Cost of Care Analyst Senior **...quality of care, and increasing member and provider network satisfaction. Typically works with one… more