- Molina Healthcare (Green Bay, WI)
- …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 (Green Bay, WI)
- …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 (Green Bay, WI)
- …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
- Molina Healthcare (Green Bay, WI)
- … 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
- Cornerstone Caregiving (Appleton, WI)
- Operating Director for Appleton, WI Operating Director Full-Time Appleton, WI Apply Now Apply Now Job Summary Cornerstone Caregiving, the largest privately owned ... 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
- Molina Healthcare (Green Bay, WI)
- …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
- Molina Healthcare (Green Bay, WI)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more