- 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 ... GA, Richmond, VA, Norfolk, VA or Mason, OH. 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
- Molina Healthcare (GA)
- …or other health care environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating ... Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with...5-7 years contract -related experience in the health care field including, but not limited to, provider… more
- CVS Health (Atlanta, GA)
- …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
- 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 (Macon, GA)
- …Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Utilizes standardized contract ... sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members. *...concert with Director. * Oversees the maintenance of all Provider and payer Contract Templates. Works with… more
- Elevance Health (Atlanta, GA)
- …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
- CVS Health (Atlanta, GA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... heart, each and every day. **Position Summary** Supports network teams in provider negotiations and financial risk for Commercial, Medicare, Medicaid, and IFP… more
- Centene Corporation (Atlanta, GA)
- …mental and behavioral health needs members to provide high quality, cost -effective healthcare outcomes including personalized care plans and education for ... between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services...care and quality delivery for members in a cost -effective manner + Performs other duties as assigned. +… more
- Molina Healthcare (Savannah, GA)
- …Manages a team of employees who develop, negotiate, contract and enhance provider networks that are high quality, cost efficient and improve the lives ... * Leads and manages a high performing team who develop, negotiate, contract and enhance collaborative provider relationships, ensuring overall network… more
- Humana (Atlanta, GA)
- …experience and achieving path-to-value goals through analysis and collaboration of provider contract loading and maintenance. The Value-Based Programs ... put health first** The Value-Based Programs Professional 2 supports successful value-based provider relationships in the Service Fund Department with a focus on… more
- Prime Therapeutics (Atlanta, GA)
- …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
- Sharecare (Atlanta, GA)
- …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
- CVS Health (Atlanta, GA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... the Network to determine the financial impact resulting from changes in provider contracts and payment methodologies. + Conducts in-depth analysis of healthcare… more
- Republic Services (Marietta, GA)
- …Area & Procurement leadership, the Area Procurement Manager leads strategic cost savings projects and handles tactical implementation of national procurement ... and related processes to maximize business opportunities and optimize cost for the assigned areas. This includes but is...needs with vendors in varied markets and works with contract management to finalize contract arrangements for… more
- CoreCivic (Alamo, GA)
- …and level of performance consistent with the actual job performance requirements. + Provide comprehensive nursing care to include, but not limited to, executing ... At Corecivic, we do more than manage inmates, we care for people. Corecivic is currently seeking **Advanced Registered...a good working relationship with facility staff, nursing staff, contract providers and outside provider agencies. +… more
- CoreCivic (Millen, GA)
- …medical and other problems, prescribing medications and providing treatment and follow-up care . + Provide direction in leadership for the medical program ... At CoreCivic, we do more than manage inmates, we care for people. CoreCivic is currently seeking **Physician** who...a good working relationship with facility staff, nursing staff, contract providers and outside provider agencies. +… more
- Highmark Health (Atlanta, GA)
- …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
- CenterWell (Atlanta, GA)
- …locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized ... operations team members and complete data retrieval and analysis, cost of goods and gross margin financial modeling, report...put patients at the center. As the nation's largest provider of senior-focused primary care , one of… more
- Fresenius Medical Center (Kennesaw, GA)
- …FMS/USV/FVC policy requirements. Oversees all A/R functions for USV/FVC facilities to provide timely collections on A/R balances due the company and properly ... with all applicable company, industry, and regulatory requirements. Implements cost containment strategies as appropriate. Responsible for assuring proper… more
- TEKsystems (Atlanta, GA)
- …scale, and agility to shape the future. As part of TEKsystems, a leading provider of business and technology services, we offer boutique solutions to solve complex ... functions and required skills are to qualify, conduct discovery, provide insights, and guide customers in driving impactful business...we should approach the solution, how much it will cost , etc. + Determine how we can best position… more