- AmeriHealth Caritas (Newtown Square, PA)
- …and other administrative services. Discover more about us at www.amerihealthcaritas.com . The ** Provider Network Data Oversight Analyst** performs the role ... Network Management team by performing analysis of provider data , payment term changes, and general...Network , and Operational areas to develop lenses that provide event triggered output for monitoring of impending contract… more
- Hartford HealthCare (New Britain, CT)
- …moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network . The Trauma Data Analyst is responsible for the ... Work where every *moment* matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing… 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
- Molina Healthcare (San Jose, CA)
- …such as provider contracts. **KNOWLEDGE/SKILLS/ABILITIES** + Oversees receipt of and coordinates data from the provider network for entry into the plan's ... **JOB DESCRIPTION** **Job Summary** Provider Network Administration is responsible for... provider management system. + Reviews/analyzes data by applying job knowledge and experience to ensure… more
- CareOregon (Portland, OR)
- …and templates based on data -driven insights. + Stay informed of provider network -related updates and sentiment, industry and community trends, content ... working in Medicaid or Medicare healthcare communications + Experience with data analytics tools and techniques for interpreting provider feedback and… 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
- CVS Health (Columbus, OH)
- … network providers, including tracking key performance indicators, analyzing provider performance data , and implementing performance improvement initiatives. ... + Controls the development and expansion of the company's provider network by evaluating potential network...the network 's performance and effectiveness by analyzing network data , utilization patterns, and market trends… 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...or State program requirements, working with key stakeholders and provide oversight on applicable data -sharing or report… 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 ... now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about...all products. **Key Responsibilities:** + Monitor and manage the provider network to ensure service accessibility and… more
- WellSense (Boston, MA)
- … provider types. The Snr PRC acts as liaison between behavioral health provider network and key internal health plan departments and works closely with ... Senior Provider Relations Consultant, BH Network Strategy...**Identifies system updates needed and completes research related to provider data in Onyx and Facets** +… more
- The Cigna Group (Houston, TX)
- …medical cost position of assigned markets through analysis of healthcare provider contracts, analysis of high performing network solutions, analysis of ... + Provide analytical and strategic support of health care provider rate negotiations + Identify opportunities for medical cost reduction, develop action… more
- Elevance Health (Columbus, OH)
- ** Provider Network Management Director** _Location: Alternate locations may be considered. This position will work a hybrid model (1-2 days/week in office). The ... of one of our Elevance Health PulsePoint locations._ The ** Provider Network Management Director** is responsible developing...projects with significant impact. + May assist management in network development planning. + May provide work… more
- ChenMed (Jacksonville, FL)
- …builder with those providers. This individual will use database systems to manage provider data and produce reports and analysis for the Center, Specialty, ... we need great people to join our team. The Network Representative is responsible for the establishment of a...Representative is responsible for the establishment of a Coordinated Provider List (CPL) to provide specialty care… more
- AmeriHealth Caritas (Charleston, SC)
- …services. Discover more about us at www.amerihealthcaritas.com. ; **About this job:** The Provider Network Account Executive I (AE I) is responsible for ... starts now. We're looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we're passionate about helping... provider issues.; + Monitor and manage the provider network by assuring appropriate access to… more
- The Cigna Group (Bloomfield, CT)
- …member to join our growing and dynamic LifeSource Transplant Analytics team as a Provider Contract & Network Underwriting Advisor. In this role, you will assist ... contractors in creating network solutions and provider contracts to ensure...Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide… 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 ... to ensure the Plan maintains a compliant and adequate provider network . + Network DevelopmentEvaluates...and recommends action plans, if necessary.Analyzes, interprets and communicates data related to provider performance in a… more
- The Cigna Group (Bloomfield, CT)
- …10 years of experience in healthcare leadership, value-based care strategy, and provider network management. + Minimum of 5 years of experience in clinical ... provider performance, and stronger provider relations, and solidifying network alignment through data -driven solutions and strategic collaborations. The… more
- AmeriHealth Caritas (Newtown Square, PA)
- …services. Discover more about us at www.amerihealthcaritas.com . **Position Overview:** The Provider Network Account Executive I (AE I) conducts orientation ... with all updates and revisions. **Key Responsibilities:** + Monitor and manage the provider network to ensure appropriate access to services throughout the… more
- Molina Healthcare (Columbus, OH)
- …in the United States _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the value-based payments ... and hospital contracting, etc. * Working experience with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare… more
- Molina Healthcare (Houston, TX)
- …and must live in Texas _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy ... critical provider information on all claims and provider databases. Synchronizes data among multiple claims...negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of… more