- The Cigna Group (Cleveland, OH)
- …Must reside in the Cleveland or Independence, OH area.** The **Director** **,** ** Provider Contracting Network Management** serves as an integral member of the ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- Elevance Health (Cincinnati, OH)
- Provider Network Manager ( Contract Negotiations) JR149075 **Location:** This position will work in a hybrid model (remote and office). The ideal candidate ... Coast business hours and the other will preferrably work Central Time business hours. The ** Provider Network Manager** develops the provider network for… more
- The Cigna Group (Bloomfield, CT)
- …position aligned to the Northeast Region States in the USA_** The **Northeast Region Healthcare Provider Network Lead Analyst** serves as an integral member ... assigned markets. + Lead regional market research relating to competitor provider network participation status, competitor product development, regulatory… more
- Sharp HealthCare (San Diego, CA)
- …Management Department to provide education and communicate information to the provider network . (ie Regional Council Meetings, PCP council, Office Manager ... an assigned SCMG provider region. Works closely with the physician network , affiliated hospitals, ancillary providers, Sharp HealthCare and all departments… more
- AmeriHealth Caritas (Newtown Square, PA)
- …tools or reports designed to routinely assess and support existing and new provider network management processes, programs, contract performance, and ... lenses that provide event triggered output for monitoring of impending contract changes and provider patterns.; + Effectively prioritizes and communicates… more
- Avera (Des Moines, IA)
- …have proper documentation to join and remain in the network . + Maintain provider manual and policies and maintain contract database and associated files. + ... Forward for you and our patients. Work where you matter.** **A Brief Overview** The Provider Contract Manager is a critical member of Avera Health Plans (AHP) … more
- Corewell Health (Grand Rapids, MI)
- …+ Contributes to the contract development and negotiation process for provider network initiatives. Enters/maintains current information in the internal ... passion for problem solving? Priority Health is seeking a Provider Contract Specialist to take ownership of...E Beltline - Grand Rapids Department Name PH - Provider Network Contracting Employment Type Full time… more
- Elevance Health (Costa Mesa, CA)
- Provider Contract Consultant **Location:** CA-WOODLAND HILLS, 21215 BURBANK BLVD This position will work a hybrid model (remote and office). The ideal candidate ... 50 miles or 1-hour commute each way of a relevant Elevance Health location. The Provider Contract Consultant will be creates and manages contract templates… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III Job...for the initial on-board training of new managed care contract provider partners, and for ensuring their ... Category: Provider Relations Department: Provider Network Management Location: Los Angeles, CA,...public agency created by the state of California to provide health coverage to low-income Los Angeles County residents.… more
- AmeriHealth Caritas (Raleigh, NC)
- …services. Discover more about us at www.amerihealthcaritas.com . The Vice President, Provider Network Management, is responsible for developing and overseeing ... as a strategic advisor to executive leadership on emerging trends in provider network management, reimbursement policy, regulatory shifts, and market… more
- The Cigna Group (Bloomfield, CT)
- …position aligned to the Connecticut Market. Must live in Connecticut._** The **Contractor, Provider Network Management** serves as an integral member of the ... + Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms. +...lieu of a Bachelor degree.** + **1+ years of Provider Contracting and Negotiating for Healthcare ** **Hospital/… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …in resolution of escalated provider concerns/issues, distribution of workload, and provide peer review for contract accuracy. May develop or improve work ... Lives** Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so...serve through our Healthsource blog: https://healthsource.premera.com/ . As the ** Provider Network Executive III** , you will… more
- CVS Health (Lansing, MI)
- …claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. **Required Qualifications** + Critical ... physician groups, and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the… more
- AmeriHealth Caritas (Dublin, OH)
- …services. Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Provider Network Account Executive II (AE II) is responsible ... for all products. **Responsibilities:** + Monitor and manage the provider network to ensure service accessibility and... service complaints and negotiate solutions. + Ensure accurate contract loading and submissions and manage network … more
- AmeriHealth Caritas (Southfield, MI)
- …services. Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Provider Network Account Executive II (AE II) is responsible ... all products. **Key Responsibilities:** + Monitor and manage the provider network to ensure service accessibility and... service complaints and negotiate solutions. + Ensure accurate contract loading and submissions, and manage network … more
- Elevance Health (Washington, DC)
- …location. The ** Provider Network Management Director** develops the provider network through contract negotiations, relationship development, and ... ** Provider Network Management Director** **Location:** This...projects with significant impact. + May assist management in network development planning. + May provide work… more
- CVS Health (Columbus, OH)
- …terms and conditions. + Controls the development and expansion of the company's provider network by evaluating potential network providers, negotiating ... healthcare providers to ensure a comprehensive and high-quality network . + Contributes to optimizing the network 's...A minimum of 10 years professional work experience in provider network management. + A minimum of… more
- Sharp HealthCare (San Diego, CA)
- …virtually, and conducts physician, hospital and/or ancillary meetings, as necessary.Ensures provider network meets all regulatory and accreditation requirements ... orientation/training and other resources to educate providers and key provider staff on Plan products, processes, and contract...to ensure the Plan maintains a compliant and adequate provider network . + Network DevelopmentEvaluates… more
- Elevance Health (Costa Mesa, CA)
- …commute each way of the listed Elevance Health locations. **Develops the PPO provider network through contract negotiations, relationship development, and ... link between professional providers and the company. + Ensure that network composition includes an appropriate distribution of provider specialties.… more
- AmeriHealth Caritas (Asheville, NC)
- … provider issues. The position also involves monitoring and managing the provider network to ensure appropriate access to services, maintaining financial ... now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about...multiple locations or specialties. + Monitor and manage the provider network to ensure compliance with state… more
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