- JEFFERSON INDUSTRIES CORPORATION (West Jefferson, OH)
- …Product Quality Planning. Our facilities support high quality product manufacturing, and we provide a timely and flexible approach to meeting the needs of our ... (SNAP). *Establish Daily, Weekly & Monthly reviews and reflections using CAPDo. COST *Supports the development and management of Weld Department budget and costs.… more
- 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 ... 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
- Elevance Health (Columbus, OH)
- ** Provider Contract / Cost of Care Consultant** **Locations:** This role requires associates to be in-office **1-2** days per week, fostering collaboration ... NOTE: This position is not eligible for current or future VISA sponsorship._ The ** Provider Contract / Cost of Care Consultant** provides analytical… more
- Elevance Health (Mason, OH)
- ** Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration ... granted as required by law. The ** Provider Contract Cost of Care Analyst...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Columbus, OH)
- ** Provider Contract Cost of Care Consultant - VBC** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consultant...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Molina Healthcare (OH)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads...department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates.… more
- The Cigna Group (Cleveland, 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
- The Cigna Group (Cleveland, OH)
- …analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. + Manages key provider ... understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models. + Team player with proven… more
- CVS Health (OH)
- …provider meetings. + May collaborate cross-functionally on the implementation of large provider systems, to manage cost drivers, data reports and execute ... 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 (Cincinnati, OH)
- Provider Success Consultant Sr. (Ohio Market) **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... This position will require the candidate to travel to provider locations in Ohio at a minimum of 50%...at a minimum of 50% of the time. **The Care Consultant Sr.** is responsible for fostering long-term partnerships… more
- Molina Healthcare (OH)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Columbus, OH)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- OhioHealth (Columbus, OH)
- … site goals on delivering on the value equation of quality, service, and cost efficiency, while maintaining an exceptional provider and staff culture. This role ... everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover...goals. Growth - Through the Clinical Enterprise standard processes, provide strategic and operational direction in support of the… more
- Molina Healthcare (Dayton, OH)
- …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
- Molina Healthcare (Dayton, 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 (Columbus, OH)
- …other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) + ... Builds work breakdown structures, monitors task activities, and ensures state contract timelines are met. Monitors the project from inception through delivery.… more
- Molina Healthcare (Cincinnati, OH)
- …claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and ... cost containment reports and makes recommendations based on relevant...materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of… more
- Humana (Columbus, OH)
- … efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration. The RVP ... and maintain trusted relationships with CMOs and senior executive/clinical leaders at provider and care delivery partner organizations. First and foremost, this… more
- Intermountain Health (Columbus, OH)
- …in care . Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved ... and training techniques. Based on medical record metrics and contract obligations, conducts patient outreach and follow up in...the efforts of providers and practice teams on office-based care delivery interventions resulting in cost of… more
- Molina Healthcare (Dayton, OH)
- …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more
