- Elevance Health (Rocky Hill, CT)
- The Cost of Care Mgr leads and manages...acumen. + 2 years experience in broad-based analytical, managed care payor or provider environment as well as ... multiple cost of care initiatives enterprise wide (eg local, within each state,... improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual… more
- The Cigna Group (Bloomfield, CT)
- …address customer and client demands for lower cost and higher quality of care . This role will report to the Provider Contracting Director - LifeSOURCE and ... targets new providers to bring in network + Incorporates contract and compliance standards into provider agreements...organizations + Strong understanding and experience with hospital, managed care , and provider business models + Knowledge… more
- Sedgwick (Hartford, CT)
- …negotiate fee-for-service ancillary contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and ... Taking care of people is at the heart of...or university preferred. **Experience** Four (4) years of progressive provider network contract negotiation experience or equivalent… more
- The Cigna Group (Bloomfield, CT)
- …working 3 days per week onsite and 2 days per week remote._** The Provider Contracting Advisor (PCA) is responsible for the overall management of the Behavioral ... consists of identified large, high-volume, multi-state or national practices that provide virtual and digital resources. These regional and/or national outpatient… more
- Humana (Hartford, CT)
- …caring community and help us put health first** The Senior Contract Management Professional negotiates and maintains complex Subcontract Agreements, Teaming ... and applicable file documentation in support of a US Government Prime Contract in accordance Company Policy and Contractors' Purchasing Systems Review (CPSR)… more
- Hartford HealthCare (Wethersfield, CT)
- …of health care finance and/or accounting issues . Knowledge of cost accounting and EPSi highly desired . Strong interpersonal and communication skills essential ... the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst develops a modeling process for negotiated… more
- Sharecare, Inc. (Hartford, CT)
- …-effective manner while ensuring high quality care . The RN coordinates with the Primary Care Provider and all other members of the health care team to ... increasing acuity, and for intervening with the participants and their Primary Care Provider according to the disease management program intervention guidelines.… more
- The Cigna Group (Bloomfield, CT)
- …of our practice is: + Comprehensive Health Risk Assessments (HRA): health plans contract with ENHB care to conduct in-home comprehensive health assessments in ... a division of Cigna, is the premier home-based healthcare provider and medical services company. We are an innovative,...**Duties & Responsibilities:** + Works to achieve quality medical care and outcomes for patients, in a cost… more
- Option Care Health (Hartford, CT)
- …alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly ... resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than...treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through… more
- Hartford HealthCare (Hartford, CT)
- …the organization is supported through data and evidence-based evaluation of cost containment, utilization, standardization and contract compliance opportunities. ... leaders to develop sound business case by integrating multiple sources of data ( cost & clinical). Serves as a subject matter expert to promote and educate… more
- Elevance Health (Rocky Hill, CT)
- …for autism and depression, and insightful analytics to improve the delivery of care .** **BH Care Manager II** Responsible for authorizing and reviewing ... needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract .… more
- Elevance Health (Rocky Hill, CT)
- **Behavioral Health Care Manager II** **This is a remote, individual contributor role; however, it is expected for the person in this role to live in the state of ... 8:30 am to 5 pm EST.** The Behavioral Health Care Manager II is responsible for managing psychiatric and...access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines… more
- CVS Health (Hartford, CT)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary: Do you want to make… more
- Elevance Health (Rocky Hill, CT)
- …needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract . ... + Will serve as a resource to other BH Care Managers. + Assists with more complex cases and...or any combination of education and experience which would provide an equivalent background. + Current active unrestricted license… more
- Elevance Health (Wallingford, CT)
- …needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract . ... + Will serve as a resource to other BH Care Managers. Assists with more complex cases and may...or any combination of education and experience which would provide an equivalent background. + Current active unrestricted license… more
- The Cigna Group (Bloomfield, CT)
- …as needed. + Strong understanding of Provider Contracting & contract negotiations. In-depth understanding of managed care business processes, data, ... non-technical stakeholders. + Deep familiarity with health insurance data, including contract structure and methodologies, claims, eligibility, provider and… more
- IMSolutions, LLC (Hartford, CT)
- …to work at the agency's office in Washington, DC._** As a **Federal Contract Specialist** , you provide acquisition support services, including contract ... and contract closeouts. + Market research/analysis, selection and administration of contract terms and conditions, cost , and price analysis. + US Citizenship… more
- Prime Therapeutics (Hartford, CT)
- …satisfaction. Develops and tracks the appropriate metrics to monitor the quality and care cost impact of the client's program. Requires communication across all ... 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… more
- Sedgwick (Hartford, CT)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... To analyze complex or technically difficult surety and surety bond claims; to provide resolution of highly complex nature and/or high exposure surety claims; to… more
- Prime Therapeutics (Hartford, CT)
- …outcomes. Develops and tracks the appropriate metrics to monitor the quality and care cost impact of client programs. Requires coordination and communication ... and analysis. Demonstrates the value of pharmacy solutions (unit cost , utilization management & patient care enhancements)....achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more