- CVS Health (Richmond, VA)
- …health care more personal, convenient and affordable. Position Summary The Medicaid Network Provider Relations Manager oversees our Medicaid Provider ... Minimum of 5 to 7 years' experience in Provider Relations ; experience in Medicaid servicing or managing...work with others at all levels * Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing,… more
- CVS Health (New York, NY)
- …convenient and affordable. Position Summary The Senior Manager of Provider Relations manages a team of Provider/ Network Relations representatives ... of 3 years recent Managed Care experience in Provider Relations , Network Operations, and/or Network ...+ Experience with Employee Supervision and leading teams + Medicaid Network experience + Knowledge of … more
- CVS Health (Frankfort, KY)
- …to make health care more personal, convenient and affordable. Position Summary The Sr. Manager Medicaid VBC KY/WV manages and oversees compliance with our ... Managed Care Network Value Based Contracting experience with 2-3 years Medicaid Network experience* Must have Microsoft Office experience with intermediate… more
- CVS Health (Hartford, CT)
- …suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting to the Senior Manager of Medicaid Risk ... Adjustment, the Market Manager of Medicaid Risk Adjustment will work closely with cross-functional leadership...of the team. + Partner with segment product, sales, network , clinical teams to implement processes aimed at strengthening… more
- CVS Health (Hartford, CT)
- …and analysis to inform solutions, close gaps and maximize the provider network .Required Qualifications - 4+ years' experience Medicaid servicing or managing ... internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. Manages provider contracting intake process… more
- Humana (Indianapolis, IN)
- …2) who are responsible for the day-to-day front line relationship management of network providers for Humana's Healthy Horizons in Indiana, as well as responsible ... The Provider Education & Outreach Representatives serve as the primary relationship manager with providers to ensure positive provider experience with Humana Healthy… more
- CVS Health (Harrisburg, PA)
- …relationships by assisting with or responding to complex issues regarding Medicaid policies and procedures, plan design, contract language, service, claims or ... request to enhance quality metrics and relationship building + Coordinate with Network Management to issue provider CAP + Monitor Grievances according NCQA standards… more
- Molina Healthcare (Springfield, IL)
- …and must live in Illinois _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, ... and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and… more
- Highmark Health (Charleston, WV)
- …Description :** **JOB SUMMARY** This job manages a team of provider relations ' representatives and staff to provide high quality service to providers participating ... in the organization's network . The incumbent motivates a team through the creation...the office** **ESSENTIAL RESPONSIBILITIES** + Manage team of provider relations representatives and support staff in servicing health systems… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …implementation when needed. + Serve as a primary spokesperson for SMCH on government relations matters. + Build a network of key external stakeholders who can ... and purpose of the job. The Senior Vice President & Chief Government Relations Officer (SVP & CGRO) provides strategic oversight and is responsible for government… more
- CareOregon (Medford, OR)
- …is a federal contractor and must comply with all federal laws. Job Title Network Support Manager Exemption Status Exempt Department Jackson CCO Manager ... Title Director, Clinical Integration - CCO Direct Reports Matrix Manager for JCC's Panel Coordinators, Quality Improvement Analyst, Provider Relations … more
- Dignity Health (Oxnard, CA)
- …types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to ... Paid Time Off and Sick Leave. **Responsibilities** The Provider Relations Representative is responsible for establishing and maintaining positive relationships… more
- CVS Health (Sacramento, CA)
- …thinking, problem resolution and interpersonal skills - Experience in provider relations activities including claims issue resolution, adding new locations, general ... or Mountain time zones - Experience supporting compliance/regulatory activities including network adequacy reporting, network gap mitigation activities and… more
- CVS Health (Oklahoma City, OK)
- …experience in Provider Relations & Employee Supervision with 2 - 3 years Medicaid Network experience + Excellent interpersonal skills and the ability to work ... care more personal, convenient and affordable. Position Summary The Medicaid Sr. Manager , Provider Engagement manages and...with others at all levels + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing,… more
- Lancaster General Health (Lancaster, PA)
- …or weekends required. **POSITION SUMMARY:** Under the direction of the Nurse Manager , the Assistant Nurse Manager assesses, plans, implements and evaluates ... the primary duties listed above:** + In collaboration with the Nurse Manager , counsels employees and takes appropriate disciplinary action for infractions of policy.… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of purpose:** The ... Manager works closely with their counterpart to assist the...to the development and implementation of processes and workflows, network development, contract management, claims, billing, and authorization assistance.… more
- Amergis (Chicago, IL)
- …with direct product and/or direct program experience in contract compliance, government relations and/or provider network . + Two years of experience managing ... Local Pay : $50/ hr Position - Manager of Complex Care Coordination Location: Chicago, IL...RN + Three years of health plan experience in Medicaid or other government lines of business or health… more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... for internal departments (ie Claims, Finance, Care Management Services, Patient Relations , Marketing, Credentialing, Provider Relations , etc.). + Researches,… more
- CenterLight Health System (Flushing, NY)
- JOB PURPOSE: The Account Manager - Veteran will be responsible to drive growth for CenterLight Healthcare Inc.'s Program of All-inclusive Care for the Elderly (PACE) ... through referral source network building; developing lead-optimization strategies, plan education; and by helping develop community engagement events to proliferate… more
- Magellan Health Services (Albuquerque, NM)
- …Engagement Manager Grade 23 Work Experience - Required Community Relations /Outreach Work Experience - Preferred Education - Required Associate Education - ... Collaborates with multiple departments, including peers, business development, marketing, network contracting, and provider liaison teams. + Participates as a… more