- Point32Health (Canton, MA)
- …**Job Description** Key Responsibilities/Duties - what you will be doing (top five): Provider Network Strategy and Development + Develop provider networks ... who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Director of Contracting is responsible for contract strategy, development,… more
- Centene Corporation (Jefferson City, MO)
- …Purpose:** This role will be a leader on the team responsible for building, contracting , and managing the provider network for Ambetter Health Solutions ... - Centene's ICHRA focused role. This includes overseeing activities of the provider contracting and network development functions for a national footprint -… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Director , Provider Contracting serves as a strategic leader overseeing ... to drive successful outcomes and support the organization's overall objectives. The Director , Provider Contracting communicates contract terms, payment… more
- Highmark Health (Camp Hill, PA)
- …PHOs, physicians, intermediate care providers). Directs financial analyses of the provider 's payment history, develops approaches to manage the payout consistent ... methodologies used to reimburse institutional and professional providers. Implements network contract and reimbursement initiatives as indicated by enterprise and… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- … Contracting and is responsible for developing and executing US payer and provider contracting strategies, tactics, and initiatives in partnership with the US ... fulfil their aspirations. Join Kite and help create more tomorrows. **Job Description** The ** Director , US CAR-T Pricing & Contracting ** reports to the Head of… more
- Molina Healthcare (Green Bay, WI)
- **Job Description** **Job Summary** Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina ... caring manner.' **Knowledge/Skills/Abilities** * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and… more
- WellSpan Health (York, PA)
- …new hospital additions as applicable, in accordance with System Care Contracting Team. Includes all traditional medical components (hospital, WMG, Apple Hill, ... home infusion, VNA, DME) and Value-Based Purchasing. + Collaborates with contracting leadership to identify and understand challenging operational issues with payor… more
- Walmart (Bentonville, AR)
- …and lead new contracting opportunities (eg immunization, value-based models, network expansion) to expand Walmart's role in payer- provider partnerships. ... **What You'll Bring:** + Significant leadership experience in PBM, payer contracting , or network negotiations especially overseeing high-value accounts. +… more
- Point32Health (Canton, MA)
- …utilized by Point32Health to understand performance, financial or otherwise, of the allied provider network . Work closely with the contract management staff and ... Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for...of financial and legal terms. The Manager, Allied Health Contracting will work closely with the Director ,… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …relationship management on behalf of CHLA, CHLA Medical Group, CHLA Health Network and their subsidiaries as applicable. Will support CHLA Medical Group leadership ... Will also be responsible for collaboration and communication between Enterprise Contracting and other key stakeholder departments within CHLA and CHLA Medical… more
- Beth Israel Lahey Health (Wakefield, MA)
- …a difference in people's lives.** Position Summary: Partner with the Executive Director , Contracting to manage key divisional initiatives that support Managed ... Care Contracting . The Contracting Program Manager will be...as, licensing projects, new service lines and locations, and provider additions to BILHPN. This will involve high levels… more
- Corewell Health (Grand Rapids, MI)
- …Master's Degree (MBA, MHA, MHP) + 5 years of relevant experience within provider network management, health care insurance or other health care delivery ... costs, cost-savings opportunities, best practices, provider performance issues, provider compensation and network expansion. + Support market specific… more
- Highmark Health (Pittsburgh, PA)
- …field **EXPERIENCE** **_Minimum:_** + 7 - 10 years' experience in managed care network development and provider relations/ contracting management in a ... business network strategy (government, commercial, etc.). Leads all aspects of provider network strategy including, but not limited to: discounts analysis,… more
- Humana (Indianapolis, IN)
- …+ 5+ years of experience in healthcare operations, finance, medical economics and/or provider network management + 3+ years of experience HEDIS/Stars experience, ... improving consumer experiences **Preferred Qualifications** + Master's Degree + Provider Contracting experience **Additional Information** At minimum, a… more
- Magellan Health Services (Boise, ID)
- …to unmet needs, and adequacy of the provider network to provide member choice of providers, and contracting with qualified service providers in ... in the successful development of the provider network including network development, contracting ,...development. Knowledge of NCQA requirements. General Job Information Title Director , Network Development Grade 30 Work Experience… more
- Corewell Health (Grand Rapids, MI)
- …seniority and benefits. About the RoleAs Manager of Provider Network Contracting , you will partner with the Director to lead a team of professionals ... providers to ensure annual goals are achieved. + Provide advice/guidance/recommendations to corporate and regional executives and business...E Beltline Ave NE - Grand Rapids Department Name Provider Network Contracting - PH… more
- CVS Health (Hartford, CT)
- …and long-term strategic planning. The Executive Director will oversee network management and provider relations, while also crafting a forward-looking ... improve access to care. Aetna is seeking an Executive Director to lead the First Health business with full...Leading the strategic development and expansion of the company's provider network by evaluating potential network… more
- AmeriHealth Caritas (Delaware County, PA)
- … of Network Adequacy leads the strategic integration and utilization of provider network adequacy, availability, and access data to drive network ... plan operations and meet regulatory reporting requirements. + Model and drive network development opportunities throughout the contracting lifecycle to address … more
- UNC Health Care (Morrisville, NC)
- …improve the health and well-being of the unique communities we serve. Summary: The HCS Director of Managed Care Contracting serves as one of the Health Care ... to develop plants to execute such projects. The HCS Director of Managed Care Contracting will optimize...least 7 years of progressive experience in managed care contracting within a healthcare provider or payer… more
- Molina Healthcare (St. Clair Shores, MI)
- …and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... information on all claims and provider databases. Responsible for contracting /re- contracting of standard deals, maintaining network adequacy, issue… more