- BPA Health Inc (Boise, ID)
- …The successful candidate possesses expertise, direct experience with and understanding of the provider network management core processes that results in a ... preferred but not required. Preferred experience: 5 years leadership experience preferred Provider Network Management experience preferred Knowledge of Idaho… more
- Molina Healthcare (Boise, ID)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Boise, ID)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Meridian, ID)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Evolent (Boise, ID)
- …Account teams and payer clients to align priorities and deliver high-quality provider network engagement, performance reporting, and present to health plans ... OR THE WEST REGION We are seeking a strategic and collaborative Associate Director , Provider Engagement to lead our oncology-focused provider engagement… more
- Molina Healthcare (Meridian, ID)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Sedgwick (Boise, ID)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Provider Network Specialist **PRIMARY PURPOSE** **:** To ensure clients and ... MCO provider on physician credentialing, MCO additions and removals, network and problematic issues. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **ARE YOU AN… more
- St. Luke's Health System (Boise, ID)
- …of colleagues, St. Luke's is truly a great place to work. The ** Director of Clinical Review Management ** provides strategic and operational leadership across ... multiple settings and operating units to lead the organization's utilization management function in support of SLHS mission, vision, and strategic objectives. **What… more
- Datavant (Boise, ID)
- …to customer outcomes, regulatory drivers, and market trends in risk adjustment, care management , and provider enablement. + Identify and prioritize use cases ... is powered by the largest, most diverse health data network in the US, enabling data to be secure,...across different facets within prospective and concurrent solutions. + Provide mentorship, performance management , and career development… more
- Idaho Division of Human Resources (Boise, ID)
- …position ensures the continuum of giving grows over time. The Annual Giving Director leads all customer relationship management (CRM) systems and processes, ... IPTV Annual Giving Director Posting Begin Date: 2025/10/08 Posting End Date:...and Idaho's only locally owned and operated statewide broadcast network . We are a state agency under the Idaho… more
- Merck (Boise, ID)
- …world-class Asset Management , Maintenance and Reliability (MRAM) program across a network of ~30 manufacturing sites. This role will own the design, deployment ... role for a technical change agent with broad global experience in asset management , maintenance, reliability and systems engineering. **What you will do** + Lead the… more
- Datavant (Boise, ID)
- …of Internal Audit will evaluate the effectiveness of internal controls, risk management practices, and governance processes across Datavant's Provider , Payer, ... is powered by the largest, most diverse health data network in the US, enabling data to be secure,...realize our bold vision for healthcare. **Role Summary:** The ** Director of Internal Audit** will design, implement, and oversee… more
- Cardinal Health (Boise, ID)
- …we can get life-changing therapies to patients who need them-faster.** The Director of Business Development, Patient Hub Services, is responsible for business ... of Access and Patient Support, Clinical Services and Reimbursement Services. The Director will build key customer relationships to uncover customer needs to align… more
- Celestica (Boise, ID)
- …financial commitments. * You will be part of our development's team global program management network where you will influence our program management ... managers to support the market/site strategic plan and continuously provide coaching and mentoring to the project management... provide coaching and mentoring to the project management team to ensure career development. * Be responsible… more
- Molina Healthcare (Boise, ID)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract Specialists on negotiation of...models. Seeks input on new reimbursement models from Corporate Network Management , legal and VP level engagement… more
- Highmark Health (Boise, ID)
- …cross organizational programs and projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2 years Understanding of ... provider contract documents and overall contract management process **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Excellent… more
- Sumitomo Pharma (Boise, ID)
- …the design and execution of program operations, systems, metrics, and HUB vendor network . The Director will work closely with key stakeholders including the ... seeking a dynamic, highly motivated, and experienced individual for the position of ** Director , Patient & HUB Operations, Rare Disease** . The Director , Patient… more
- Cornerstone Caregiving (Boise, ID)
- Operating Director for West Boise, ID Operating Director Full-Time West Boise, ID Apply Now Apply Now Job Summary Cornerstone Caregiving, the largest privately ... expand nationwide, we are searching for an exceptional Operating Director to lead this branch's growth. Supported by our...this branch's growth. Supported by our homebase and a network of Operating Directors, you will play a pivotal… more
- Bristol Myers Squibb (Boise, ID)
- …environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work ... lives. Read more: careers.bms.com/working-with-us . **Position Summary:** The Associate Director of Strategic Accounts will be responsible for optimizing access… more
- Molina Healthcare (Boise, ID)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
