- Humana (Columbus, OH)
- …pm in the central or eastern time zone + Previous experience in provider contracting and/or negotiations/sales **Preferred Qualifications** + Knowledge of the ... ACCOUNTABILITIES -** + Develop and maintain a cost effective provider network in the required PSAs. Requirements include achieving...TRICARE program and other Government contracting experience as well as the different reimbursement methodologies… more
- Elevance Health (Columbus, OH)
- …or jeopardize network retention. + Serves as a knowledge expert regarding LTSS provider contracting and has a broad understanding of LTSS credentialing ... key areas. + Serves as a communication link between professional providers wishing to join the LTSS network. +...fee schedules is strongly preferred. + Experience with LTSS provider contracting and credentialing is a huge… more
- OhioHealth (Columbus, OH)
- …a major contributor for the development and managements of the provider network through contract negotiations, relationship development and maintenance. Assists in ... program(s) and client(s') needs for adequacy. Responsible for successfully negotiating provider agreements with reimbursement in keeping with the health plan's… more
- CVS Health (Columbus, OH)
- …parties **Preferred Qualifications** + Familiar with legal terms in the context of provider contracting + Familiar with CMS Stars and HEDIS technical ... value-based contracting targets and manage medical costs through effective value-based contracting . + Provide assistance and support to other departments, as… more
- Jacobs (Columbus, OH)
- …as the primary point of contact as you monitor the contractor's performance and provide technical advice to the Contracting Official and contractor within the ... your success, and the global community - join us as a Contracting Officer's Technical Representative(COTR)/Resident Engineer (RE) to support the Amtrak ADA Stations… more
- Elevance Health (Columbus, OH)
- …Requires a BA/BS degree and a minimum of 5 years' experience in contracting , provider relations, provider servicing; experience should include prior ... is not eligible for employment based sponsorship **Develops the provider network through contract negotiations, relationship development, and servicing. Primary… more
- Humana (Columbus, OH)
- …+ 2 or more years of health care or managed care experience with provider relations, provider contracting , or network management + Experience in ... Plan in Ohio seeks highly motivated Engagement Professionals to provide end to end provider experience as...as a member of our Medicaid team. The Senior Provider Engagement Professional develops and grows positive,… more
- Elevance Health (Columbus, OH)
- … and facility contracts across value based and fee for service agreements for provider solutions. + Works directly with contracting directors and managers to ... ** Provider Contract Specialist Manager** Carelon Behavioral Health _Location:...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities and Experiences:**… more
- Cardinal Health (Columbus, OH)
- …approval processes, developing and executing account strategies. + Demonstrate professional development initiatives: keep abreast of competitive landscape, market ... communicate across key internal and external stakeholders. + Oversee all contracting activity within the account, to include providing leadership and direction… more
- Elevance Health (Columbus, OH)
- …gaps and ad-hoc training needs. + Works collaboratively with Network Support, Contracting , and external stakeholders to ensure LTSS provider qualification ... education and internal health plan support to mitigate issues related to provider operations, contracting and provider claims submissions. + Mentors,… more
- CVS Health (Columbus, OH)
- …guidelines in support of global and regional network strategies. Expand International provider network by contracting new direct pay providers and manage ... international network, medical cost management and overall claim/customer service strategies. Provide concierge level of service to our members via timely provision… more
- Meta (Columbus, OH)
- …roles to join our Design, Engineering & Construction (DEC) organization to direct contracting across the full E2E project lifecycle of data center campuses in North ... contract management function at the program level, including custom contracting strategies, first-of-kind product and deal solutions, contracts management tooling… more
- Centene Corporation (Columbus, OH)
- …plan and State guidelines. + Oversee all negotiations for a specific plan or provider type (large professional groups, hospitals, etc.) + Assist with plan ... Marketing, related field or equivalent experience. 4+ years of contracting or provider relations experience in a healthcare, managed care, or insurance… more
- Cardinal Health (Columbus, OH)
- …At-Home Solutions ("AHS") business clients, a leading home healthcare medical supplies provider serving people with chronic and serious health conditions in the ... laws and regulations applicable to the AHS business. **_Responsibilities_** * Provide legal guidance on various healthcare laws, regulations, and subregulatory… more
- General Motors (Columbus, OH)
- …and supporting the design and implementation of financial reporting and government contracting processes, systems and controls for GMD. This position requires an ... and Defense industry and internal and external controls associated with government contracting . This role will serve as a strategic business partner to shape… more
- CBRE (Columbus, OH)
- …Rico - United States of America Full Spectrum Lab Services from CBRE offers a professional suite of services to a variety of clients in the life sciences industry, ... Proposal Support: Collaborate with the business development and proposal teams to provide input and support for the preparation, review, and submission of proposals… more
- Humana (Columbus, OH)
- …closely with our local market Provider Engagement, MRA, Clinical, & Contracting leadership to provide support through complex analytics and reporting. The ... Senior Analyst role will also provide insights for financial opportunities for our Medicare Value-Based...IN, MI, KY, & WV. The Senior Market Finance Professional collects, analyzes and reports on various market data… more
- CenterWell (Columbus, OH)
- …our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate ... network management, and payment frameworks (eg capitation, partial risk, direct contracting ) + Population health minded physician with an understanding of, and… more
- EMCOR Group (Columbus, OH)
- …owned subsidiary of EMCOR Group, Inc. EMCOR is the world's leading provider of mechanical and electrical construction and facilities services, including planning, ... AND RESPONSIBILITIES** + Work with Project Managers and other team members to provide quality and timely service, correspondence, and other needs to our customers… more
- Molina Healthcare (Columbus, OH)
- …waste, or abuse. + Coordinates with various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, ... identify outlier billing behavior, contract and program regulation research, provider and member education, findings identification and communications development,… more