- CVS Health (Lansing, MI)
- …large physician groups, and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the ... each and every day. **Position Summary** In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high… more
- CVS Health (Frankfort, KY)
- …Qualifications** + A minimum of 3 years work experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience ... every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health… more
- CVS Health (Annapolis, MD)
- … options, financial/ contracting arrangements and regulatory requirements. + Medicaid Network Management experience, preferably Maryland Medicaid ... cost initiatives. **Responsibilities** **include:** + Analyzes market needs and opportunities for network expansion, identifies gaps in the existing network , and… more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, ... and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex… more
- Albany Medical Center (Albany, NY)
- …other related departments. The Director builds external relationships with payers' senior network management, leads meeting, oversees and/or prepares ... and employee related activities, as applicable, under the System Payer Contracting Unit. The Director prepares annual budget target recommendations in conjunction… more
- Providence (Irvine, CA)
- …and litigation, and advising on legal issues affecting Providence's clinical network . **Key Position Responsibilities:** + Payor Contracting & Reimbursement ... + Translate complex legal and reimbursement issues into clear, decision-ready guidance for senior leaders. + Providence Clinical Network : + Provide legal support… more
- Molina Healthcare (Rochester, NY)
- …on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through financial and ... **Job Description** **Job Summary** Sr. Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation… more
- Molina Healthcare (NM)
- …on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through financial and ... **Job Description** **Job Summary** Sr. Analyst, Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation… more
- Integra Partners (Troy, MI)
- The Senior Medical Director ( Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is ... business hours, with additional availability as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s),… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network ... are the primary point of contact between Molina Healthcare and contracted provider network . They are responsible for the provider training, network management… more
- Cardinal Health (Hartford, CT)
- …Pharmacy Benefit Management (PBM) companies and Health Plans. Responsibilities include contracting activities, network and performance participation for Cardinal ... **_What Network and Payor Relations contributes to Cardinal Health_**...strategic opportunities for all lines of business including Medicare, Medicaid , and various commercial markets. The Advisor of Managed… more
- Providence (Santa Monica, CA)
- …5-star rating for quality, safe care from the Centers of Medicare and Medicaid Services (CMS). Purchased Services and Physician Contracting provides contract ... **Description** Senior Contract Sourcing Program Manager at Providence Saint...and counsel on matters for the Providence South Division. Contracting services are provided according to divisional and regional… more
- AmeriHealth Caritas (Southfield, MI)
- … senior leadership and strategic direction to the market network management teams in developing and maintaining effective, high-performing market networks. ... AmeriHealth Caritas's executive leadership. **Responsibilities:** + Leads comprehensive provider contracting strategy to achieve cost-efficient and high-performing network… more
- Saint Francis Health System (Tulsa, OK)
- …**to login and apply.** Full Time Job Summary: The Senior VP, Chief Population Health Officer (CPHO) will be reporting ... for Saint Francis Health System in value-based payment models (Commercial, Medicare, Medicaid ). In addition, the CPHO is responsible for providing expertise and… more
- CenterWell (Phoenix, AZ)
- …Degree + 5 or more years of Health care or managed care with Provider Contracting , Network Management or Provider Relations experience. + Some travel required to ... of our caring community and help us put health first** The Senior Provider Engagement Professional develops and grows positive, long-term relationships with… more
- CenterWell (Phoenix, AZ)
- …relationship with specialist, hospitalist, SNF and other providers to form a narrow network of quality service focused on senior population health + Responsible ... physician recruitment needs and collaborate in the hiring and contracting of providers. + Establish work schedules and assignments...and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to five… more
- CVS Health (Albany, NY)
- …+ Advance working knowledge of business systems, applications, and tools supporting network management, contracting , and provider data systems + Experience in ... controls through collaborating with cross-functional teams. This position will support network across all lines of business. + Understanding business operations to… more
- Commonwealth Care Alliance (Boston, MA)
- …the provider relations team. Cross-Functional Collaboration * Work closely with network contracting , credentialing, claims, IT, customer service, compliance, and ... in coordination with network , operational, clinical, and compliance teams. Network Performance & Compliance * Collaborate with contracting , operations, and… more
- Molina Healthcare (Saginaw, MI)
- …* Resolves complex provider issues that may cross departmental lines including Contracting , Finance, Quality, Operations, and involve Senior Leadership. * ... strategic network planning tools to drive Provider Relations and Contracting Strategy across the enterprise. * Facilitates strategic planning and documentation… more
- Humana (Richmond, VA)
- …to provide thought leadership for Humana Group Medicare. + Assisting with network development and provider contracting , as well as product development ... clinical performance, risk adjustment, and stars. This CMO frequently interacts with the senior management team when representing Group MA with the Group MA SVP. In… more