- Elevance Health (Atlanta, GA)
- ** Cost of Care / Provider Contracting Data Analyst** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... an accommodation is granted as required by law. The ** Cost of Care / Provider Contracting...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Atlanta, GA)
- …Senior** is responsible for providing analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering ... cost of care . + Educates provider contractors on contracting analytics from a...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Atlanta, GA)
- …Provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims ... cost of care + Educates provider contractors on contracting analytics from a...or any combination of education and experience which would provide an equivalent background. **Preferred Qualifications:** + Experience providing… more
- Elevance Health (Atlanta, GA)
- …standardized practices to optimize cost of care . + Educates provider contractors on contracting analytics from a financial impact perspective. + ... ** Provider Contract/ Cost of Care ... Care Consultant** provides analytical support to the Provider Contracting , Product and Solutions organizations. Focuses… more
- The Cigna Group (Atlanta, GA)
- **WORK LOCATION: Atlanta, GA** The **Director** ** Provider Contracting Network Management** serves as an integral member of the Provider Contracting Team ... and reports to the AVP, Provider Contracting . This role assists in developing the strategic direction...degree.** MBA or MHA preferred. + **3+ years Managed Care contracting and negotiating experience involving complex… more
- Molina Healthcare (Atlanta, GA)
- …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including ... Provider Community that result in high quality, cost effective and marketable providers. Contract/Re- contracting with...cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads… more
- The Cigna Group (Atlanta, GA)
- …Compliance, Sales and Marketing and Service. + Manages strategic positioning for provider contracting , develops networks and identifies and acts upon ... total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist… more
- Centene Corporation (Atlanta, GA)
- …Two years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- CVS Health (Atlanta, GA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... managing relationships with third-party vendors to ensure optimal performance, compliance, contracting and alignment with organizational goals to ensure the delivery… more
- Highmark Health (Atlanta, GA)
- …Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population health ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2… more
- Fortive Corporation (Atlanta, GA)
- …For you, for us, for growth. **About Gordian** Gordian is the world's leading provider of facility and construction cost data, software and services for all ... Gordian is the leader in facility and construction cost data, software, and services for all phases...the building lifecycle. As the pioneer of Job Order Contracting (JOC), Gordian delivers innovative solutions including proprietary RSMeans… more
- Molina Healthcare (Atlanta, GA)
- …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...departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
- Molina Healthcare (Atlanta, GA)
- …health plans on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Atlanta, GA)
- …health plans on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Atlanta, GA)
- …senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations ... in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment,… more
- CDM Smith (Atlanta, GA)
- … cost estimates and supporting analysis in coordination with government cost estimators and contracting officers. * Participate in pre-construction meetings, ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- CVS Health (Atlanta, GA)
- …positively impact our patients' health. As a Medical Economics Analyst, you will provide consultative support and medical cost -based analysis of markets and ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we... issues * Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting … more
- Prime Therapeutics (Atlanta, GA)
- …address changing market demands and ensure Prime is delivering the highest quality and lowest cost of care to its members and related client messaging as well as ... pipeline to capitalize on savings through effective negotiation and contracting + Develop strong working relationships and communication at...different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for… more
- Molina Healthcare (Atlanta, GA)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost -effective based on the severity ... that support ongoing improvements of clinical operations functions and promote quality cost effective health care for Molina members. + Develops initiatives… more
- Molina Healthcare (Atlanta, GA)
- …etc. **PREFERRED EXPERIENCE:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, ... through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care . + Ensures that… more