- Molina Healthcare (Miami, FL)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy...large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider… more
- Oracle (San Antonio, TX)
- …+ Proficient in Microsoft Office suite. **Responsibilities** The Customer Deal Desk Specialist III leads and manages the contracting process end-to-end for ... This is not a remote role.** **Customer Deal Desk Specialist III** An ideal candidate has a strong work... III sets the overall direction for his/her assigned managed deal(s) and is responsible for the successful execution… more
- HCA Healthcare (Campbell, CA)
- …of health plan economics analyses, metrics and health plan reporting in a Managed Care environment relating to the financial, quality and operational performance ... Come join our team as a Health Plan Economics Specialist . We care for our community! Just...for Health plan Metrics, Analytics and Reporting for a Managed Care organization + Develop and maintain… more
- UPMC (Pittsburgh, PA)
- …complex situations accurately and in a timely manner. + General knowledge of managed care functions and management techniques preferred. + Computer Skills with ... Care Behavioral Health is hiring a full-time Contract Specialist III. This role will work in a hybrid...contracting with the provider for services. The Contract Specialist III reviews and approves any alterations in the… more
- Intermountain Health (Helena, MT)
- …rules, payer under and/or overpayment trends, opportunities in billing, and opportunities with managed care contracting efforts. + Log findings and provides ... feedback to Hospital Billing AR Management, Cash Management, and Managed Care leadership. + Perform root cause...contracts are aligned with original intent of health system contracting efforts. + Work with Compliance, Finance and Government… more
- Houston Methodist (Sugar Land, TX)
- …+ Maintains knowledge of Federal, State, and local billing regulations and partners with managed care contracting as needed. + Maintains knowledge of ... determinations and, denial reason and trending as appropriate, Monitors CMS, managed care and payor communications for updates/alerts/releases and functions… more
- Vistra (Glen Rose, TX)
- …are currently available and apply online. **Job Summary** The Procurement Specialist is responsible for driving savings and implementing contractual protections for ... the company. Tasks include leading sourcing events as well as facilitating the contracting and procurement processes. A solid knowledge of all aspects of the… more
- CareFirst (Baltimore, MD)
- …years' experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in managed care ; state or federal health care programs; or health ... Utilizes extensive coding knowledge, combined with medical policy, credentialing, and contracting rules knowledge to help build the effective guides and resources… more
- Dignity Health (Bakersfield, CA)
- …database maintenance and reporting, provider contracting and/or network development in a health care or managed care setting - HS diploma or GED - ... is maintained in each region. The Provider Data Management Specialist is an employee of Dignity Health Management Service....pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to… more
- Penn Medicine (Plainsboro, NJ)
- …significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare ... regulations and requirements + Ability to develop a good working relationship with managed care organizations, and provide excellent customer service + Ability… more
- Amgen (Washington, DC)
- …and memberships), contracts, strategies, and rebates and fee transactions for payer ( managed care ), channel, and provider rebates. + Works cross-functionally ... Join us and transform the lives of patients while transforming your career. ** Specialist IS Business Systems Analyst - Product Team** **What you will do** Let's… more
- Waystar (Atlanta, GA)
- …Develop and maintain strong relationships with payers, including health insurance companies, managed care organizations, and government agencies. + Create new, ... **ABOUT THIS POSITION** The Payer Relations Specialist is responsible for initiatives to identify and...performance. + Track and communicate the status of payer contracting and connections activities **OPTIONAL DETAILS --Looking for… more
- Veterans Affairs, Veterans Health Administration (Huntington, WV)
- Summary The Mobility Transportation Specialist functions as a subject matter expert in all matters of beneficiary travel and modes of veteran transport for the ... transportation to Veterans who require assistance traveling to and from VA health care facilities and authorized non-VA health care appointments within the… more
- Dignity Health (Bakersfield, CA)
- …care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, ... **Job Summary and Responsibilities** The Contract Specialist II, reporting to the Network Operations/ Contracting...with a business objective to excel in coordinating patient care in a manner that supports containing costs while… more
- Veterans Affairs, Veterans Health Administration (Charlotte, NC)
- …of the Supply Chain Management Service in a Veteran Affairs Health Care System and supported catchment area, with responsibility for the inventory management ... matter expert to all services and service lines. Inventories managed include a wide variety. of expendable items and...materially affect the VA HCS' ability to provide medical care to Veterans. Researches opportunities for and conducts analysis… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- Summary This position serves as an Inventory Management Specialist (EX) in the Supply Chain Management Service at the Veteran Affairs Health Care System San ... matter expert to all services and service lines. Inventories managed include a wide variety of expendable items and...materially affect the VA HCS' ability to provide medical care to Veterans. Researches opportunities for and conducts analysis… more
- Nuvance Health (Danbury, CT)
- …on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting team with necessary contractual language to ... * Current working knowledge of utilization management, performance improvement and managed care reimbursement. Education: BACHELOR'S LVL DGRE Working Conditions:… more
- Helio Health Inc. (Syracuse, NY)
- …Guidelines. + Coordinates services with external case managers, managed care operators, licensing, funding, and contracting agencies. + Provide excellent ... support the mission of Helio Health, Inc., theFinancial Management Unit Specialist (Representative Payee) is responsible for the day-to-day interaction with patients… more
- RTX Corporation (Mckinney, TX)
- …a security clearance **Security Clearance:** DoD Clearance: Secret **Raytheon Company, Managed by Collins Aerospace** We are currently seeking an experienced ... and have good working knowledge of company business systems and policies, contracting processes and earned value management techniques. + Collaborate with PLT to… more
- Centene Corporation (Nashville, TN)
- …services experience required, including experience in a managed health care environment with exposure to provider contracting , servicing benefits ... interpretation, and internal operations of provider relations.Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid… more