- Elevance Health (Mason, OH)
- ** 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 (Cincinnati, OH)
- ** 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
- The Cigna Group (Independence, OH)
- …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
- Molina Healthcare (Columbus, OH)
- …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 (Columbus, OH)
- …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
- Molina Healthcare (Cincinnati, OH)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... : * 5-7 years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider ...or matrix leadership position * 3+ years experience in provider contract negotiations in a managed healthcare… more
- Humana (Columbus, OH)
- …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
- Molina Healthcare (Cleveland, OH)
- …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 (Cincinnati, OH)
- …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
- Elevance Health (Mason, OH)
- …and Experiences:** + MBA preferred. + Applicants with proven expertise in provider contract interpretation and negotiation are strongly preferred. + Strong ... web-based provider directories. + Determines resource needs and develops cost estimates for executive management. + Hires, trains, coaches, counsels, and… more
- Bon Secours Mercy Health (Cincinnati, OH)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... people in mind, body and spirit through exceptional patient care . Success in this goal requires a culture of...associates want to work and help communities thrive. **GPO Contract Administrator (Senior Paralegal) - Supply Chain and GPO**… more
- CVS Health (New Albany, OH)
- …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
- Option Care Health (Columbus, OH)
- …engaging and rewarding for all team members. Our organization requires extraordinary people to provide extraordinary care , so we are investing in a culture that ... infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality...resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than… more
- Molina Healthcare (Akron, OH)
- …goals of the department and organization. + Oversees the maintenance of all provider contract information and templates and ensures that all negotiated contracts ... and implement provider contracting and service strategies to contain unit cost , improve member access and enhance provider satisfaction with the Plan.… more
- Molina Healthcare (Cincinnati, OH)
- …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
- Intermountain Health (Columbus, OH)
- …with scorecard initiatives with assigned care providers program metrics. + Consults with care team to provide care coordination for preventative care ... and training techniques. Based on medical record metrics and contract obligations, conducts patient outreach and follow up in...efforts of providers and practice teams on office based care delivery interventions resulting in cost of… more
- Bon Secours Mercy Health (Lima, OH)
- …age of the patient population served: ☒ Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or ... Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our...to his or her age, specific needs and to provide the care needed as described in… more
- Prime Therapeutics (Columbus, OH)
- …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 (Columbus, OH)
- …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