- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- + GENERAL SUMMARY + The Leader , Managed Care Contracting , is responsible for all aspects of payer contract negotiations, network management, and ... managed care organizations (MCOs). The Leader , Managed Care Contracting...Lead the revalidation efforts to maintain compliance with managed care organizations, Medicaid, and other payer… more
- Prime Therapeutics (Richmond, VA)
- …with Rebate contracts, or within Medicare/Medicaid (eg insurance, government program operations, managed care practices, and/or provider contracting ) + ... or contractual requirements + May serve as a team leader and mentor to junior level team members and...support to internal and external business partners + May lead department contracting strategy for junior level… more
- The Cigna Group (Mclean, VA)
- …to work in the office or visit Providers 3 days per week The **Provider Contracting Lead Analyst** serves as an integral member of the Provider Contracting ... reports to the Contracting Manager or Market Lead . This role assists and supports the day to...and managing relationships + Understanding and experience with hospital, managed care , and provider business models a… more
- Humana (Richmond, VA)
- …in Medicaid VBP contract development, operational set-up, and execution. The Value Based Contracting Lead requires in-depth understanding of VBP and the ... payment structures and reimbursement rates to providers + Experience in negotiating managed care contracts with primary physician groups or other specialty… more
- The Cigna Group (Richmond, VA)
- …relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with ... visit Providers 3 days per week The **Manager, Provider Contracting ** serves as an integral member of the Provider...Hospital systems, Ancillaries, and large physician groups). + May lead a team with direct reports. + Point person… more
- Humana (Richmond, VA)
- …will have extensive business leadership experience, with several years in a managed care environment leading a network development/provider relations function, ... leader for the position of Regional Vice President, Contracting . The Regional Vice President (RVP) will foster the...Medicare lines of business. In addition, the RVP will lead the transition of targeted membership and providers to… more
- Elevance Health (Norfolk, VA)
- …or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience ... highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you...large scale enterprise wide initiatives and acts as project lead . Acts as a strategic partner to management. +… more
- Elevance Health (Norfolk, VA)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... Consultant** will provide analytical support to the Cost of Care and/or Provider Contracting organizations. **How you...Works on complex enterprise-wide initiatives and acts as project lead . * Uses analytic tools to track both health… more
- Elevance Health (VA)
- …or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... Consultant** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts...Works on complex enterprise-wide initiatives and acts as project lead . **How you will make an impact:** * Creates… more
- Elevance Health (Norfolk, VA)
- …or related field and a minimum of 3 years' experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... Analyst Senior** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- HCA Healthcare (Salem, VA)
- …You will provide medical consultation on contracting , pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... you will do in this role: + You will lead clinical performance expectations that support the goals of...regarding delegated utilization management and disease management operations under managed care contracts. You will meet all… more
- EAB (Richmond, VA)
- …strategy, planning, and execution of 100+ in-person and 600+ virtual events annually. We lead with an innovative approach, a high level of attention to detail, and ... unparalleled level of service. Events managed by the team include industry tradeshows, largescale summits,...critical support in two distinct areas: Event Sourcing and Contracting and Pre-Event Support for VIP events, playing a… more
- HealthEdge Software Inc (Richmond, VA)
- …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and healthcare plan operations (eg, claim life cycle/workflow, network contracting , payment/policy configuration, provider relations, medical management, medical economics,… more
- Highmark Health (Richmond, VA)
- …or other master's level clinical degree preferred. + 7-10 years of experience in a managed care , hospital or other clinical setting preferred. + Formal Lean Six ... models + Experience in health plan provider network performance management, care /case management, provider relations, provider contracting , etc. **Preferred** +… more
- Intermountain Health (Richmond, VA)
- …Scope 1) This position manages and trains a team of professionals who lead consistent and progressive initiatives. 2) This position manages all supply chain aspects ... business service line(s). 3) This position has oversight of the sourcing/ contracting /procure-to-pay process, as well as experience in customer and supplier… more