- Molina Healthcare (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …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 (Las Cruces, NM)
- …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 (Las Cruces, NM)
- … 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
- Molina Healthcare (Las Cruces, NM)
- …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
- Molina Healthcare (Las Cruces, NM)
- …+ 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
- Molina Healthcare (Las Cruces, NM)
- …care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Provides ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
- Community Health Systems (Las Cruces, NM)
- …is also responsible for working with Clinic Leadership and the DPO to maintain network labels in the AMR (Athena, Cerner, etc.) to support Network Integrity ... monitor and improve utilization. This includes, when appropriate, reviewing monthly provider utilization data and working with the Corporate Optimization Director… more
- CACI International (Las Cruces, NM)
- …as a Mission IT Operator supporting a 24x7 government mission. You will provide direct support for detecting, isolating, and resolving ground segment problems; and ... Do: - Responsible for resolving IT hardware and software infrastructure (servers, network , security, etc.) issues using systems - Analysis techniques and procedures.… more
- LifePoint Health (Las Cruces, NM)
- …is responsible for patient assessment, treatment, airway and ventilator management , establishes therapeutic objectives, diagnostic evaluation and care of patients ... system during the transport process, under the direction of the Medical Director . * Associate's degree in Applied Science/Respiratory Therapy - Required * Must… more
- LifePoint Health (Las Cruces, NM)
- …we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as an employee, but ... (5) years current clinical experience in specialty area or management . Three (3) to five (5) years experience in...Summary * Clinical Manager, under the direction of Program Director , manages and coordinates the clinical and other activities… more