- CVS Health (Chicago, IL)
- … growth, and efficiency targets. Manages and oversees compliance within our network responsibilities as provided within the state Medicaid contractual ... * Minimum of 5+ years' working experience in Provider Relations or Network Strategy * Minimum 5+...Network Strategy * Minimum 5+ years' experience in Medicaid Managed Care business segment environment with exposure to… more
- CVS Health (Columbus, OH)
- …minimum of 3 years work experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. + Proven working ... every day. **Position Summary** Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health… more
- CVS Health (Frankfort, KY)
- …within 3 hours of the capital.** **Preferred Qualifications** + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, ... by assisting with or responding to complex issues regarding Medicaid policies and procedures, plan design, contract language, service,...Provider Appeals & Disputes, and Network Performance Standards. + Professional experience in behavioral health… more
- Elevance Health (Ashburn, VA)
- …employment, unless an accommodation is granted as required by law._ **The Network Relations Consultant** develops and maintains positive provider relationships ... the understanding of managed care policies and procedures. + Identifies network access and deficiencies and develops recruitment and contracting strategies. +… more
- Molina Healthcare (Saginaw, MI)
- …**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : * 4-6 years provider contract network relations and management experience in a managed healthcare ... and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development,… more
- Abbott (Livermore, CA)
- …health and get on with their lives. This position leads payor relations (including payor contracting) and regulatory affairs, which are foundational functions to ... payor contract negotiation, payor contract implementation, payor contract monitoring, Medicare/ Medicaid enrollment, state licensing, and Joint Commission accreditation +… more
- Commonwealth Care Alliance (Boston, MA)
- …provider network operations, education, and performance improvement. The Provider Relations Director reports to the Sr Director of Delegation Partnerships and ... network performance against internal and regulatory benchmarks. * Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. *… more
- Commonwealth Care Alliance (Boston, MA)
- …to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead provider servicing activities, including ... By fostering strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital role in helping CCA… more
- CVS Health (Helena, MT)
- …thinking, problem resolution and interpersonal skills - Experience in provider relations activities including claims issue resolution, adding new locations, general ... or Mountain time zones - Experience supporting compliance/regulatory activities including network adequacy reporting, network gap mitigation activities and… more
- Elevance Health (AR)
- …as necessary. **Preferred Skills, Capabilities and Experiences:** + Medicare network contracting/reimbursement methodology strongly preferred. + Medicaid and ... Provider Network Management Director (Medicare Network Build)...role is contracting and negotiating contract terms for **Medicare, Medicaid ,** and **ACA programs** . Deals with primarily the… more
- Commonwealth Care Alliance (Boston, MA)
- …One Care) populations preferred. * Experience in healthcare program management, provider relations , or network management * Knowledge of Massachusetts BH ... Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral… more
- Commonwealth Care Alliance (Boston, MA)
- …job. **Required Experience (must have):** + 5+ years of experience in provider relations , healthcare communications, or network management within a health plan ... 011230 CA-Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and nurturing… more
- Molina Healthcare (Carson City, NV)
- …Partners with Network to communicate recovery projects so that provider relations can be informed and respond to questions from providers. **Strategic Business ... tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA- Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based ... One Care) populations preferred. + Experience in healthcare program management, provider relations , or network management + Knowledge of Massachusetts LTSS… more
- Bassett Healthcare (Cooperstown, NY)
- …340B Drug Pricing Program for all qualified entities throughout the Bassett Health Network . The 340B Manager serves as the primary institutional compliance ... the best quality of life possible. What you'll do Reporting to the Chief Pharmacy Officer, the 340B Manager is responsible for compliance and administration of the… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4762503) Apply MANAGER ... 23 health centers and four hospitals - and expanded network of community partner clinics - DHS annually provides...and administrative space. Acts as first assistant to a Manager IV, Facilities Operations and Crafts. Essential Job Functions… more
- Magellan Health Services (Albuquerque, NM)
- …Engagement Manager Grade 23 Work Experience - Required Community Relations /Outreach Work Experience - Preferred Education - Required Associate Education - ... Collaborates with multiple departments, including peers, business development, marketing, network contracting, and provider liaison teams. + Participates as a… more
- Molina Healthcare (WA)
- **JOB DESCRIPTION** **Job Summary** The Regional Manager Value Based Programs plays a critical role in the development and implementation of value-based programs and ... and LOBs. **KNOWLEDGE/SKILLS/ABILITIES** + Works directly with assigned market network leaders to identify providers for value-based contracting, support local… more
- AdventHealth (Davenport, FL)
- …been serving the community for over 50 years. As a part of the AdventHealth network patients will have greater access to a wide range of innovative therapies, new ... creativity, and resource management to achieve quality performance, positive employee relations , and compliance with hospital and American College of Cardiology… more
- AdventHealth (Lake Wales, FL)
- …been serving the community and surrounding areas. As a part of the AdventHealth network patients will have greater access to a wide range of innovative therapies, ... contribute:** The ANM is a registered professional nurse who supports the Nurse Manager or Director in overall operations of their assigned unit.Is able to… more
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