- Molina Healthcare (Lexington, KY)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Lexington, KY)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Lexington, KY)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (Lexington, KY)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Microsoft Corporation (Lexington, KY)
- The **Strategic Account Director - Healthcare Provider Industry** manages the development and application of a mature/dynamic customer plan based on proven ... partners, to ensure execution of core tasks and account transactions and to provide a comprehensive account management experience. Orchestrates the execution of… more
- CommonSpirit Health (Lexington, KY)
- …Bachelor's Degree - equivalent education and experience in payer strategy, managed care or provider network senior level role may be considered in lieu of degree ... a strong preference for someone in the KY or TN area. The Market Director , Payer Strategy and Relationships (PSR), is responsible for managed care policies, goals… more
- Molina Healthcare (Lexington, KY)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This role negotiates assigned… more
- Molina Healthcare (Lexington, KY)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- CommonSpirit Health at Home (Lexington, KY)
- …and Responsibilities** VNA Health at Home is part of an expansive health care network that is committed to providing better patient care, with better outcomes, where ... mission of delivering hope and healing to those we serve. The Director , Clinical Services is responsible for the planning, direction, coordination, supervision,… more
- Molina Healthcare (Lexington, KY)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more
- Insight Global (Richmond, KY)
- …which encompasses 500+ salary employees, 100+ virtual and physical servers, 300+ network switches,1200+ PCs and network attached devices. Supervises and trains ... other information technology analysts. Designing, installing, and implementing network infrastructure for various projects within manufacturing plants, service… more
- Danaher Corporation (Lexington, KY)
- …initiatives. This role plays a pivotal part in supporting funnel management , activity tracking, and large account planning initiatives, while partnering with ... the North America Commercial Sales Enablement team and report to the Senior Director , North America Sales Enablement responsible for CRM, CPQ, and sales enablement… more
- Catholic Health Initiatives (Lexington, KY)
- …requirements ESSENTIAL KEY JOB RESPONSIBILITIES 1. Participates in the evaluation and management of diseases and health conditions in collaboration with other health ... pharmaceutical agents as outline in the approved collaborative drug therapy management agreement including initiating, adjusting, and discontinuing drug therapy 3.… more