- Elevance Health (Richmond, VA)
- ** 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
- 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
- Humana (Richmond, VA)
- …caring community and help us put health first** The Senior Contract Management Professional negotiates and maintains complex Subcontract Agreements, and applicable ... file documentation in support of a US Government Prime Contract in accordance Company Policy and Contractors' Purchasing Systems Review (CPSR) requirements. The… more
- Humana (Richmond, VA)
- …exceeds the discount guarantee. **KEY ACCOUNTABILITIES -** + Develop and maintain a cost effective provider network in the required PSAs. Requirements include ... in order to foster greater understanding of the TRICARE program and improve cost awareness. + Ensure that newly contracted providers submit accurate initial … 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
- CVS Health (Richmond, VA)
- …data, utilization patterns, and market trends to identify opportunities for network enhancements, cost savings, and improved access to care . + Conducts market ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- CVS Health (Richmond, VA)
- …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
- Cardinal Health (Richmond, VA)
- …service, expert insights and enhanced purchasing power, you can deliver high-quality, cost -effective patient care and future-proof a practice. The Account ... market the changes along with the state of value-based care . The Account Executive will ensure a strong market...account, to include providing leadership and direction for all contract strategies, Request for Proposals (RFP) and locally negotiated… 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
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... established benchmarks including hold buckets. + Ensures scheduling of staff to promote provider productivity as well as promote quality care and fiscal… 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
- Planate Management Group LLC (Richmond, VA)
- …for engineering components + Monitor project budgets including construction costs and cost projections + Provide input on engineering schedules, budgets, and ... with technical support centers in South East Asia and East Africa, that provide program management and facilities engineering services worldwide. Planate is a small… 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
- CenterWell (Richmond, VA)
- …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
- 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
- Elevance Health (Richmond, VA)
- …more complex medical transplant issues. + Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... member access to medically necessary, quality healthcare in a cost effective setting according to contract . +...and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management… 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