- Ally (Raleigh, NC)
- …end-to-end API test automation (Python) for RESTful services, including contract tests, negative/fuzz tests, auth/entitlements, and data integrity checks--integrated ... quality tooling. * Operationalize non-functional testing: performance (latency, throughput, cost /efficiency for LLM calls), chaos/resiliency (degradations, timeouts, retries), and… more
- Elevance Health (Durham, NC)
- ** Provider Contract Cost of Care Consultant** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... The **Value Based Provider Health Econ - Provider Cost of Care Consultant...contract negotiation process. + Can work with multiple provider types, eg physician, ancillary, medical groups, or hospitals.… more
- UNC Health Care (Raleigh, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... guidelines and other regulatory and accreditation standards. **Join our growing UNC Urgent Care provider team! This is an employed position with UNC Rex… more
- UNC Health Care (Butner, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... problem-solving, decision-making, and evaluating clinical/system issues and models of care . Leads interdisciplinary teams to provide integrated delivery… more
- CVS Health (Raleigh, NC)
- …and support to the AM team for Salesforce. In addition, the role will provide support to AMs in contract administration function required to submit request ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Elevance Health (Durham, NC)
- …goals as identified during assessment. + Supports member access to appropriate quality and cost effective care and modifies plan(s) as needed. + Coordinates with ... \#HealthyBlueCareTogetherCFSP **Clinical Care Advisor - IDD** **$3,500 SIGN ON BONUS**...accordance with federal/state law, scope of practice regulations or contract , the requirements are:** + Requires an active and… more
- Elevance Health (Raleigh, NC)
- …goals as identified during assessment. + Supports member access to appropriate quality and cost effective care and modifies plan(s) as needed. + Coordinates with ... welfare system so that they receive seamless, integrated, and coordinated health care . Within the Children and Families Specialty Plan (CFSP), and regardless of… more
- Highmark Health (Raleigh, NC)
- …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
- UNC Health Care (Chapel Hill, NC)
- …scale projects, and recommend proposals as appropriate to upper management. Develop cost estimates and provide recommendations for corrective work. 7. Negotiate ... of the facilities and spaces owned, leased, and maintained by the UNC Health Care System. **This position is responsible for the oversight of the General Maintenance… more
- Elevance Health (Durham, NC)
- **Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual Preferred** **Location - Virtual:** This role enables associates to work virtually full-time, ... as part of a rotating schedule._ The **Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual...access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines… more
- UNC Health Care (Morrisville, NC)
- …grounds, facilities, and infrastructure for NC Children's. **Responsibilities** : 1. Provide overall management of multiple construction project plans, budgets, and ... project management teams, and contractors to facilitate project activities. Provide leadership, management, and supervision for professional and technical personnel… more
- CVS Health (Raleigh, NC)
- …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
- Humana (Raleigh, NC)
- …. 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 ... needs of TRICARE beneficiaries, to maximize each beneficiary's capacity for self- care , to cost -effectively achieve desired clinical outcomes and to enhance… more
- CVS Health (Raleigh, NC)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... 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 (Raleigh, NC)
- …will manage a team of software developers responsible for applications that process provider demographic, contract , and pricing information which is crucial in ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- UMB Bank (Raleigh, NC)
- …Risk, Compliance, Information Security, Finance, and Business Operations to ensure contract terms meet applicable standards and adequately protect UMB interests. You ... renewals, software license, maintenance, support, subscriptions, and/or other third-party contract commitments. This position reports to the Senior Vice President,… more
- Parsons Corporation (Raleigh, NC)
- …disability, veteran status or any other protected status. We truly invest and care about our employee's wellbeing and provide endless growth opportunities as ... planning and defining program goals, understanding client objectives, and navigating contract terms and corporate policies. **Why Parsons?** Parsons is committed to… more
- Humana (Raleigh, NC)
- …Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims ... coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are… more
- Evolent (Raleigh, NC)
- …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
- Black & Veatch (Cary, NC)
- …develop and implement the proposal win strategy on key opportunities. * Participate in cost review and influences team to provide responses with competitive ... a team of proposal managers with responsibilities from pursuit assignment to contract signing. * Manage team workload and proposal assignment activities. *… more
