- AmeriHealth Caritas (Newtown Square, PA)
- …and other administrative services. Discover more about us at www.amerihealthcaritas.com . The ** Provider Network Data Oversight Analyst** performs the role ... Network Management team by performing analysis of provider data , payment term changes, and general...Network , and Operational areas to develop lenses that provide event triggered output for monitoring of impending contract… more
- Hartford HealthCare (New Britain, CT)
- …moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network . The Trauma Data Analyst is responsible for the ... Work where every *moment* matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing… more
- The Cigna Group (Bloomfield, CT)
- …position aligned to the Northeast Region States in the USA_** The **Northeast Region Healthcare Provider Network Lead Analyst** serves as an integral member ... assigned markets. + Lead regional market research relating to competitor provider network participation status, competitor product development, regulatory… more
- Sharp HealthCare (San Diego, CA)
- …Management Department to provide education and communicate information to the provider network . (ie Regional Council Meetings, PCP council, Office Manager ... an assigned SCMG provider region. Works closely with the physician network , affiliated hospitals, ancillary providers, Sharp HealthCare and all departments… more
- LA Care Health Plan (Los Angeles, CA)
- …providers based on ongoing network adequacy analysis. Ensures timely submission of provider data , facilitates remediation of data errors, monitors ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....provider dataset is complete, accurate, and current. Provides network adequacy analysis and data to the… more
- AmeriHealth Caritas (Raleigh, NC)
- …services. Discover more about us at www.amerihealthcaritas.com . The Vice President, Provider Network Management, is responsible for developing and overseeing ... as a strategic advisor to executive leadership on emerging trends in provider network management, reimbursement policy, regulatory shifts, and market… more
- CVS Health (Columbus, OH)
- … network providers, including tracking key performance indicators, analyzing provider performance data , and implementing performance improvement initiatives. ... + Controls the development and expansion of the company's provider network by evaluating potential network...the network 's performance and effectiveness by analyzing network data , utilization patterns, and market trends… more
- AmeriHealth Caritas (Dublin, OH)
- …services. Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Provider Network Account Executive II (AE II) is responsible ... for all products. **Responsibilities:** + Monitor and manage the provider network to ensure service accessibility and...or State program requirements, working with key stakeholders and provide oversight on applicable data -sharing or report… more
- AmeriHealth Caritas (Southfield, MI)
- …services. Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Provider Network Account Executive II (AE II) is responsible ... now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about...all products. **Key Responsibilities:** + Monitor and manage the provider network to ensure service accessibility and… more
- WellSense (Boston, MA)
- … provider types. The Snr PRC acts as liaison between behavioral health provider network and key internal health plan departments and works closely with ... Senior Provider Relations Consultant, BH Network Strategy...**Identifies system updates needed and completes research related to provider data in Onyx and Facets** +… more
- Elevance Health (Columbus, OH)
- ** Provider Network Management Director** _Location: Alternate locations may be considered. This position will work a hybrid model (1-2 days/week in office). The ... of one of our Elevance Health PulsePoint locations._ The ** Provider Network Management Director** is responsible developing...projects with significant impact. + May assist management in network development planning. + May provide work… more
- Elevance Health (Costa Mesa, CA)
- …each way of the listed Elevance Health locations. **Develops the PPO provider network through contract negotiations, relationship development, and servicing. ... link between professional providers and the company. + Ensure that network composition includes an appropriate distribution of provider specialties.… more
- ChenMed (Jacksonville, FL)
- …builder with those providers. This individual will use database systems to manage provider data and produce reports and analysis for the Center, Specialty, ... we need great people to join our team. The Network Representative is responsible for the establishment of a...Representative is responsible for the establishment of a Coordinated Provider List (CPL) to provide specialty care… more
- AmeriHealth Caritas (Columbus, OH)
- …tailored provider orientation sessions, making educational visits, and resolving provider issues.;;Ensure that network provider perspectives and feedback ... now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about... provider claim dispute resolution process collaborate with Provider Network Operations to resolve Provider… more
- Centene Corporation (Olympia, WA)
- …relates to provider set up. + Provide support to the external provider representative to resolve provider data issues + Research and effectively ... respond to provider related issues + Submit provider data entries to resolve provider...Three years of experience in managed care environment, medical provider office, customer service within a healthcare … more
- AmeriHealth Caritas (Charleston, SC)
- …services. Discover more about us at www.amerihealthcaritas.com. ; **About this job:** The Provider Network Account Executive I (AE I) is responsible for ... starts now. We're looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we're passionate about helping... provider issues.; + Monitor and manage the provider network by assuring appropriate access to… more
- Sharp HealthCare (San Diego, CA)
- …virtually, and conducts physician, hospital and/or ancillary meetings, as necessary.Ensures provider network meets all regulatory and accreditation requirements ... to ensure the Plan maintains a compliant and adequate provider network . + Network DevelopmentEvaluates...and recommends action plans, if necessary.Analyzes, interprets and communicates data related to provider performance in a… more
- Centene Corporation (Phoenix, AZ)
- …the appropriate party for resolution + Receive and effectively respond to external provider related issues + Provide education on health plan's innovative ... contracting strategies + Initiate data entry of provider -related demographic information changes...oversee testing and completion of change requests for the network + Investigate, resolve and communicate provider … more
- Molina Healthcare (Columbus, OH)
- …in the United States _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the value-based payments ... and hospital contracting, etc. * Working experience with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare… more
- AmeriHealth Caritas (Newtown Square, PA)
- …services. Discover more about us at www.amerihealthcaritas.com . **Position Overview:** The Provider Network Account Executive I (AE I) conducts orientation ... with all updates and revisions. **Key Responsibilities:** + Monitor and manage the provider network to ensure appropriate access to services throughout the… more