- Guardian Life (Columbus, OH)
- …ensuring consistent adherence to network best practices, and monitoring the quality of interactions Network Development colleagues are having with ... will be responsible for designing and building training and quality programs to support Recruiting, Provider Relations,...will establish a framework and approach to enable the Network Development organization to meet the high… more
- Apex Health Solutions (Houston, TX)
- …and external stakeholders to ensure prompt and appropriate action is taken regarding provider network development related activities Supports network ... maintenance to ensure viable and adequate provider network (s) Supports the network development ...improvement in network performance Assists in monitoring network composition including review of quality , efficiencies,… more
- Trinity Health (Clive, IA)
- … network team work schedules, assignments and performance appraisals. Responsible for development of an effective provider network team, including ... directly to the PHSO Director of Operations, the PHSO Provider Network Lead maintains and evolves MercyOne's...Network (PPN) built on robust adequacy, access, and quality standards. This role serves as a liaison and… more
- AmeriHealth Caritas (Dublin, OH)
- **Manager Provider Network Management** Location: Dublin, OH Primary Job Function: Medical Management ID**: 31608 Your career starts now. We are looking for the ... education, and communication. This position is also responsible for all provider network recruiting and contracting management activities. Ensures that… more
- The Cigna Group (Los Angeles, CA)
- …position. + Identify and manages initiatives that improve total medical cost and quality . + Drives change with external provider partners by assessing clinical ... Travel out to in-person meetings with Providers._** The **AVP, Network Management** serves as an integral member of the...Management. This role is a key contributor to the development of the strategic direction and is accountable for… more
- The Cigna Group (Newton, MA)
- **LOCATION: Based in Newton, MA office** The **Manager, Provider Network Contracting** serves as an integral member of the Provider Contracting Team and ... for greater value-orientation and risk arrangements. + Contributes to the development of alternative network initiatives. Supports and provides direction… more
- Elevance Health (Alameda, CA)
- …The Provider Network Manager develops the provider network through contract negotiations, relationship development , and servicing. Primary focus of ... responsibilities will include claims payment and remittance, network management, provider credentialing, data exchange and reporting and quality oversight.… more
- The Cigna Group (Seattle, WA)
- LOCATION: This position supports the Seattle, WA market. The **Director, Provider Network Management** serves as an integral member of the Provider ... for greater value-orientation and risk arrangements. . Contributes to the development of alternative network initiatives. Supports and provides direction… more
- The Cigna Group (New York, NY)
- …to work 3 days per week in our Manhattan office._** **Assistant Vice President, Network Management, NY Market** This position serves as an integral member of the ... Contracting Team and reports to the Vice President, Network Management, NY/NJ. This role is a key contributor...NY/NJ. This role is a key contributor to the development of the strategic direction and is accountable for… more
- CVS Health (Richmond, VA)
- …as SME for less experienced team members and internal partners.* Provides network development , maintenance, and refinement activities and strategies in support ... and implementation of strategic, value-based contract relationships, maintain and enhance provider networks to meet accessibility, quality , financial goals and… more
- Highmark Health (Pittsburgh, PA)
- …and payment strategy. The role also leads the strategy and creation of provider network designs and programs. The incumbent is responsible for understanding ... provider performance in the domains of reimbursement and network programs. Specifically, the incumbent will lead the strategy... design strategy, translating product / segment needs to provider and market executives. + Oversee development … more
- AmeriHealth Caritas (Palm Beach Gardens, FL)
- ** Provider Network Account Executive I** Location: Palm Beach Gardens, FL Primary Job Function: Medical Management ID**: 29645 **Job Brief** Excellent ... working to resolve provider issues. Responsible for monitoring and managing provider network by assuring appropriate access to services throughout the Plan's… more
- Medical Mutual of Ohio (OH)
- …perform pre-employment substance abuse and nicotine testing._ **Title:** _Manager, Provider Network Informatics_ **Location:** _Ohio_ **Requisition ID:** ... Professional modeling, analysis, and reporting. Oversees system administration for the provider reimbursement rate loading process, including quality control and… more
- Hudson Headwaters Health Network (Queensbury, NY)
- If you are interested in provider opportunities with Hudson Headwaters Health Network , Please also send your CV to Jenny Leszyk at ###@hhhn.org HHHN Mission To ... in the delivery of health care services. Physicians function within their scope to provide high- quality medical care across a variety of settings that comprise… more
- Elevance Health (Indianapolis, IN)
- …send you a check, or ask you for payment as part of consideration for employment. ** Provider Network Manager** + Job Family: PND > Network Contracting + ... needed **Position Overview:** Directs the activities related to the development and maintenance of the company's Long Term Services...providers, members, and the public + Ensures the LTSS provider network has the resources, tools, and… more
- BlueCross BlueShield of Tennessee (Knoxville, TN)
- …field or equivalent work experience required _Experience_ + 3 years \- Experience in provider relations and network development with emphasis on healthcare ... educational topics, methods, and strategies to enhance compliance throughout the provider network \. + Implementing, supporting, and monitoring provider… more
- LA Care Health Plan (Los Angeles, CA)
- …position is responsible to conduct ongoing data quality auditing of LA Care's provider network data, including working with their assigned provider ... the right time. Mission: LA Care's mission is to provide access to quality health care for... Add Change Delete Workflow (PCDW) tasks by continuous provider network data quality oversight… more
- Elevance Health (Seven Fields, PA)
- …via Web-Ex. + Acts as a liaison between strategic providers and Beacon clinical, quality , provider strategy, network departments, operations, claims and ... for payment as part of consideration for employment. **BH Provider Quality Mgr (US)** + Job Family:...company HEDIS performance. + Implements strategies that meet clinical, quality , and network improvement goals through positive… more
- St. Luke's University Health Network (Easton, PA)
- …to ensure appropriate staffing levels which allow our PCA's to provide top quality care to our patients. The Network Float (Central Staffing) PCA is an ... by the challenge of providing care to patients in clinical settings across the network . The PCA is responsible for providing patient care and participates in data… more
- University of Southern Maine (Portland, ME)
- …is pleased to announce an opening for a full-time Statewide Maine Roads to Quality Professional Development Network (MRTQ PDN) Program Fiscal Associate. The ... federal, state, and university mandates and requirements. The Maine Roads to Quality Professional Development Network (MRTQ PDN) (https://www.mrtq.org/)… more