- Molina Healthcare (Waukesha, WI)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary Provides...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
- Xcel Energy (Eau Claire, WI)
- …responsible for leading work within or across end-to-end solution lifecycle. They provide IT expertise, vision, and work direction to achieve strategic initiatives, ... customer and operational needs, portfolio health and business outcomes. They provide in-depth knowledge of the business needs, processes, and corresponding… more
- Quad (Pewaukee, WI)
- …of Operations, other internal departments and HWC staff to deliver quality patient care aligned to the client service contract . + Communicates and ensures ... life. Determined to make a difference? Join our health care revolution and be a part of something better....initiatives as needed. + Maintains EHR Super User status; provide Super User support to HWC team and others… more
- Elevance Health (Waukesha, WI)
- ** Provider Contract Cost of Care Consult Senior / VBC** **Location:** This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consult...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Waukesha, WI)
- ** Cost of Care / Provider Contracting Data Analyst** **Location** : This role requires associates to be in-office 1-2 days per week, fostering collaboration ... an accommodation is granted as required by law. The ** Cost of Care / Provider Contracting Data...contract negotiation process. + Can work with multiple provider types, eg physician, ancillary, medical groups, or hospitals.… more
- Molina Healthcare (Kenosha, WI)
- …office. **Job Qualifications** **REQUIRED EDUCATION** : Bachelor's Degree or equivalent provider contract , network development and management, or project ... healthcare administration and/or Provider Services. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in… more
- Molina Healthcare (Milwaukee, WI)
- …as appropriate. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract , network development and management, or project ... provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare... Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare… more
- Molina Healthcare (Racine, WI)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Milwaukee, WI)
- …role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and ... sent to prospective new providers. * Completes and updates Provider Information Forms for each new contract ....combination of education and experience **PREFERRED EXPERIENCE** : Managed Care experience To all current Molina employees: If you… more
- Molina Healthcare (Racine, WI)
- …supports assigned contracts with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes reports according to ... Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider 's office,… more
- CVS Health (Madison, WI)
- …to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. + Negotiates settlements as needed. ... build collaborative relationships with providers and work cross-functionally to resolve complex provider contract issues. + Highly organized and able to… more
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Telephonic Care Manager (Autism Care Navigator) serves as a primary advocate for assigned ... beneficiaries receiving care under the Autism Care Demonstration (ACD)....needs through communication and available resources to promote quality, cost -effective outcomes. Coordinate medical, behavioral and other services for… more
- Veterans Affairs, Veterans Health Administration (Kenosha, WI)
- … care community. - Promotes a practice environment that empowers staff to provide compassionate and efficient care . - Demonstrates a commitment to Equal ... incumbent is the Department Head (DH) for VA Primary Care , for Evanston CBOC, for Kenosha CBOC, or for...or long-term absence of one, the remaining DHs shall provide supervisory coverage as necessary. The incumbent performs a… more
- Elevance Health (Viroqua, WI)
- …with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. + Manages non-clinical needs of members ... law._ Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to...(BH)/LTSS needs, as required by applicable state law and contract , and federal requirements. Anthem is very excited to… more
- Leaffilter (Kaukauna, WI)
- …to-dos into achievements. With more than 50% of homeowners worried about the cost and effort of home maintenance, we deliver remarkable, end-to-end experiences. And ... across the US and Canada, we are America's largest direct-to-consumer full-service provider of branded home services and products. Our products, including the… more
- Elevance Health (Darlington, WI)
- …granted as required by law._ Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to offer the Family ... Care Program. Family Care is a Wisconsin...members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. +… more
- Highmark Health (Madison, WI)
- …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
- Molina Healthcare (Green Bay, WI)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. * Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Molina Healthcare (WI)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. + Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Wolters Kluwer (Madison, WI)
- …technology (HIT) provider working on the front lines of clinical care . Our talented team of physician and pharmacist editors, technologists, and product ... solutions that measurably improve clinical effectiveness by helping healthcare professionals provide optimal care for their patients. **Wolters Kluwer Health's… more
