- Elevance Health (Atlanta, GA)
- ** Provider Contract / Cost of Care Consultant** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Provider Contract / Cost of Care...or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- Elevance Health (Atlanta, GA)
- ** Provider Contract / Cost of Care Consultant** **Locations:** This role requires associates to be in-office **1-2** days per week, fostering collaboration ... NOTE: This position is not eligible for current or future VISA sponsorship._ The ** Provider Contract / Cost of Care Consultant** provides analytical… more
- Elevance Health (Atlanta, GA)
- ** Provider Contract Cost of Care Consult Senior / VBC** **Location:** This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consult...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Atlanta, GA)
- ** Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration ... granted as required by law. The ** Provider Contract Cost of Care Analyst...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Atlanta, GA)
- ** Provider Contract Cost of Care Consultant - VBC** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consultant...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- The Cigna Group (Atlanta, GA)
- **Work Location: Atlanta, GA** The **AVP, Provider Contract Network Management** serves as an integral member of the Network Management & Affordability Team and ... total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist… more
- Molina Healthcare (Atlanta, GA)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads...department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates.… more
- Centene Corporation (Atlanta, GA)
- …account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. + Serve ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- Centene Corporation (Atlanta, GA)
- …account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. + Serve ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- Molina Healthcare (Atlanta, GA)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Elevance Health (Atlanta, GA)
- **Behavior Health Care Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ The **Behavior Health Care Manager II** will be responsible for managing psychiatric and substance abuse or… more
- Molina Healthcare (Atlanta, GA)
- …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
- Intermountain Health (Atlanta, GA)
- …in care . Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved ... and training techniques. Based on medical record metrics and contract obligations, conducts patient outreach and follow up in...the efforts of providers and practice teams on office-based care delivery interventions resulting in cost of… more
- Molina Healthcare (Atlanta, GA)
- …claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and ... cost containment reports and makes recommendations based on relevant...materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of… more
- Molina Healthcare (Atlanta, GA)
- …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more
- Elevance Health (Atlanta, GA)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental ... for autism and depression, and insightful analytics to improve the delivery of care . **Virtual** - This role enables associates to work virtually full-time, with the… more
- Highmark Health (Atlanta, GA)
- …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
- Elevance Health (Atlanta, GA)
- …employment, unless an accommodation is granted as required by law._ The BH Care Manager is responsible for managing psychiatric and substance abuse or substance ... needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract .… more
- CVS Health (Atlanta, GA)
- …for VBC contracts, working with both internal and external partners, to provide medical cost and outcomes focused analytical research, financial modeling, ... against business and team objectives + Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets… more
- Emory Healthcare/Emory University (Atlanta, GA)
- … Service, you will develop, implement, and evaluate systems that promote high-quality, cost -effective, and safe care . Key Responsibilities: + Leadership & Team ... a culture of collaboration, excellence, accountability, and mutual respect within inter-professional care teams. + Provide education, coaching, and guidance to… more