- Elevance Health (Richmond, VA)
- …promoting a dynamic and adaptable workplace. Alternate locations may be considered. The ** Provider Contract / Cost of Care Consultant Senior** provides ... the highest level of analytical support to the Cost of Care and/or Provider ...develop contracting strategy and supports all aspects of the contract negotiation process. Works with multiple provider … more
- Elevance Health (Richmond, VA)
- ** Provider Cost of Care Analyst Senior**...to Medical Directors, contract negotiators and management on cost of care issues to help reduce costs ... and adaptable workplace. Alternate locations may be considered. The ** Provider Cost of Care Analyst...from a financial impact perspective. + May recommend alternative contract language and may go on-site to provider… more
- CVS Health (Richmond, VA)
- …to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. + Negotiates settlements as needed. ... contract negotiator: + Negotiates competitive contracts with health care providers using pre-determined internal guidelines and financial standards. + Negotiates… more
- The Cigna Group (Richmond, VA)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team… more
- CVS Health (Richmond, VA)
- …value based providers in one line of business, less complex Value Based Care models, and/or less sophisticated and smaller provider partnerships, practices, or ... arrangements are functioning successfully and working to improve quality of care while reducing costs. **Key Responsibilities:** + Provider Relationship… more
- Humana (Richmond, VA)
- …extensive business leadership experience, with several years in a managed care environment leading a network development/ provider relations function, including ... seeking an accomplished healthcare leader for the position of Vice President, National Provider Network Management. At a high level, this highly visible role will be… more
- Elevance Health (Richmond, VA)
- …to the market. + Provide analytical support for strategic initiatives, such as contract negotiations, provider network optimization, and total cost of ... strong communication and interpersonal skills. + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Prime Therapeutics (Richmond, VA)
- …value to the customer, derived from identifying, demonstrating and selling valued pharmaceutical care and cost solutions that meet the desired outcomes of the ... fashion. + Demonstrates the value of pharmacy solutions (unit cost , utilization management & patient care enhancement)....achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Humana (Richmond, VA)
- …. The case manager will offer guidance. support, and coordination of the beneficiary's care as directed by the beneficiary, the provider (s) or other members of ... health needs of TRICARE beneficiaries, to maximize each beneficiary's capacity for self- care , to cost -effectively achieve desired clinical outcomes and to… more
- Sharecare (Richmond, VA)
- …while ensuring high quality care . The Clinical Registered Nurse coordinates with the Primary Care Provider and all other members of the health care team ... increasing acuity, and for intervening with the participants and their Primary Care Provider according to the disease management program intervention guidelines.… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …of clinic performance, including but not limited to: productivity, scheduling, cost efficiency, provider ongoing clinical performance reviews, staff yearly ... for a qualified and skilled Neurologist who will be responsible for direct patient care with various neurological disorders. They should be able to deliver quality … more
- Highmark Health (Richmond, VA)
- …products and services, covering the Payor market, considering factors such as cost , market dynamics, and competitive landscape. Additionally, provide insight ... products, including a core administrative platform, modular utilization and care management solutions, patient-focused digital products, and clinical data exchange… more
- Generac Power Systems (Richmond, VA)
- …day management of the design, procurement and construction of a project including cost , schedule and quality control. Works directly with the client as the client's ... and sub-contractors. Directs the site management team, design team, contract administration, construction accounting, and others as required to assure… more
- Evolent (Richmond, VA)
- …years of professional experience in claims-based healthcare analytics with a payer, provider , clinical vendor, managed care , or related healthcare consulting ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Bon Secours Mercy Health (Midlothian, VA)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... of all people in mind, body, and spirit through exceptional patient care . Success in this goal requires a culture of compassion, collaboration, excellence,… more
- Elevance Health (Colonial Heights, VA)
- …state law and contract ; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health ... care across the care continuum. **How you...members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. +… more
- CDM Smith (Richmond, VA)
- …project delivery teams by developing moderately to highly complex schedule and cost baselines. This role involves collecting and analyzing monthly schedule and ... cost data, identifying variances, and assisting in root cause...major projects and/or portfolio of projects in accordance with contract specifications. Evaluates and raises project early warning signals… more
- Prime Therapeutics (Richmond, VA)
- …empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If ... area of Prime Therapeutics. This position is also responsible for assisting contract negotiators and working with other internal departments regarding the financial… more
- Overland Contracting (Richmond, VA)
- …for Black & Veatch in all interactions involving the Owner and Contract . Implements Black & Veatch standards and procedures, develops project specific procedures ... for deviations are submitted when necessary. Manages overall construction and startup cost to meet established budgets. Reviews, analyzes, and reports monthly on… more
- CDM Smith (Richmond, VA)
- …or structure damaged by a disaster. * Reviews, evaluates and analyzes applicant-provided cost claims for reasonableness and accuracy as related to the scope of work. ... for the use of applicant-owned equipment while performing eligible work. * Develops cost estimates using RS Means software. * May coordinate and complete basic to… more