- Cigna (Richmond, VA)
- …Cigna's competitive position. Creates and manages initiatives that improve total medical cost and quality. Drives change with external provider partners by ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. Creates... partners Intimate understanding and experience with hospital, managed care , and provider business models Team player… more
- 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 ... an accommodation is granted as required by law. 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
- The Cigna Group (Richmond, VA)
- …improve total medical cost and quality. + Drives change with external provider partners by offering consultative expertise to assist with total medical cost ... + Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms. +...managing relationships + Understanding and experience with hospital, managed care , and provider business models a plus… 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
- 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)
- …activities. Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. ... for escalated issues related to claims payment, policies, accuracy of provider demographic information and contract interpretation. + Educates providers… 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 ... market-based, behavioral health groups and facility providers. You will manage contract performance and support the development and implementation of strategic,… more
- Elevance Health (Richmond, VA)
- …is granted as required by law. **Work Shift:** 8AM -5PM CST **Behavioral Health Care Manager l** The **Behavioral Health Care Manager I** is responsible for ... 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 (Richmond, VA)
- The **Behavioral Health Care Manager I - Virginia** is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and ... needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract .… 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
- Western Digital (Richmond, VA)
- …The ideal candidate will have extensive experience in supplier negotiations, contract management, cost reduction strategies, and commodity market analysis. ... key supplier relationships, driving strategic sourcing initiatives, and ensuring cost -effective procurement across specific commodity categories. This is a principal… more
- Elevance Health (Richmond, VA)
- …guidelines. + Supports quality improvement activities. + May assist with implementation of cost of care initiatives. + May attend meetings to review UM ... determination, accurate interpretation/application of benefits, corporate medical policy and cost efficient, high quality care ; manages consultation with… 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
- HCA Healthcare (Richmond, VA)
- …Envisioned, founded and supported by a group of independent physicians looking to provide high-quality care in an accessible community setting, Henrico Doctors' ... medical coverage that covers many common services at no cost or for a low copay. Plans include prescription...and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. +… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …looking for a skilled BE/BC Hematologists/Oncologist. The incumbent physician is expected to provide comprehensive patient care in the form of consultative, and ... inpatient and outpatient hematology/oncology patient care including monitoring parental and oral anti-cancer therapy administration...to grow your career. The city also boasts a cost of living that is 4.9% lower than the… 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
- 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
- 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 ... retail, mail, specialty, and quality-based networks aligning with Prime's Supply Chain Cost of Goods Sold (COGS) and network management strategies. This includes… 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 ... is responsible for performing multifaceted financial analyses to assess manufacturer contract performance, plan performance and to develop rebate estimates related… more
