- Highmark Health (Pittsburgh, PA)
- … provider inventive and payment strategy . The role also leads the strategy and creation of provider network designs and programs. The incumbent ... + Develop and maintain HPN network design strategy , translating product / segment needs to provider...MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office- or Remote -based Teaches / trains others Occasionally Travel from the… more
- AmeriHealth Caritas (Washington, DC)
- ** Provider Network Account Executive II** Location: Washington, DC Primary Job Function: Medical Management ID**: 34148 **Job Brief** The Provider Network ... services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Provider Network Account Executive II (AE II)is responsible… more
- CareFirst (Baltimore, MD)
- … contracting in accordance with guidelines in order to maintain and enhance the provider network and to meet accessibility, quality and financial goals. In ... contracts meet the need of key stakeholders. Manages the provider contract including negotiations, level of network ...and gain consensus with other internal areas affected by network changes. + Provide ongoing network… more
- The Cigna Group (Sandy, UT)
- …aligned to the Utah markets. Must reside in Salt Lake City, UT_** The **Manager, Provider Network Management** serves as an integral member of the Provider ... and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide guidance or expertise to… more
- Guardian Life (Columbus, OH)
- **Position Summary** As a member of the Network Strategy and Enablement team, the Network Training and Quality Assurance Manager will be responsible for ... training and quality programs to support Recruiting, Provider Relations, and Provider Operations ensuring consistent adherence to network best practices, and… more
- Centene Corporation (Tampa, FL)
- …role will focus on leading and supporting priority initiatives encompassing network strategy , development, management/refinement, risk mitigation, and providing ... on provider needs, and product knowledge + Translation of corporate/ network /product goals into tactics, and performance toward those goals + Ensure critical… more
- Molina Healthcare (Las Vegas, NV)
- …positive operational and financial outcomes. **KNOWLEDGE/SKILLS/ABILITIES** + Establishes the strategy and operational direction for provider engagement and ... **Required Experience:** + Min 5 years' experience in managed healthcare administration and/or Provider Services. + Provider contract network development &… more
- Experian (Costa Mesa, CA)
- …across the regional team and business units to drive consensus views to inform our strategy . You will advise senior leaders, and provide insight and expertise to ... #uniquelyexperian Please note, we have openings for two areas: Strategy Manager, Market Insights Strategy Manager, NA...target of 15% + This role can be 100% remote long-term or you can work out of one… more
- Danaher Corporation (New York, NY)
- …the Manager, Network Security responsible for architecture and service delivery of Network Security covering 150 remote sites globally, 5 data centers, and ... Services department located in North America and will be remote . At Beckman Coulter, our vision is to relentlessly...and engineering validation in the lab. + Participate in strategy definition and execution for enterprise network … more
- EVOTEK, Inc. (Los Angeles, CA)
- …innovation. With an integrated set of technical domains, including data center, network , security, cloud, and communications, EVOTEK provides a cohesive approach to ... Business Journal's "Best Places to Work" and recognized in CRN's "Solution Provider 500" list, CRN's "Next-Generation 250" list, CRN's "Triple Crown" and highlighted… more
- Medical Mutual of Ohio (OH)
- …based on history. Measures accuracy of projections. . Analyzes effectiveness of provider network performance through financial modeling, network ... **_This is a remote opportunity. Note, quarterly/ad-hoc/situational on-site requirement in Brooklyn,...the availability of information needed to analyze effectiveness of provider network performance, model proposed changes, and… more
- Humana (Columbia, SC)
- … strategy demands constant negotiation with a variety of provider constituencies and continual re-prioritization of corporate and consumer needs. Analyzes ... on network composition and needs. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues regarding technical approach… more
- Molina Healthcare (Grand Rapids, MI)
- … and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of individual provider… more
- Highmark Health (Pittsburgh, PA)
- …levers (solutions, tools, products, etc.) and the associated resource model to a given provider and/or the provider network . Responsible for gaining ... external provider engagement and communication approach that that impacts the provider network . Implement communication plan and tactics associated with … more
- Molina Healthcare (Richmond, VA)
- … and must live in Virginia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract Specialists on negotiation of individual provider and routine… more
- Highmark Health (Pittsburgh, PA)
- … system, and among the provider network . Responsible for setting the provider support model strategy and leading the team of resources deployed with our ... Organization (ECO), and other enterprise functions in relation to supporting the provider network . This includes executing upon all transformation levers with… more
- Centene Corporation (West Allis, WI)
- …the provider network and contracting activities. Lead all aspects of provider network strategy including, access analysis, network operations and ... across expansion markets. + Perform periodic analyses of the provider network from a cost, coverage, and...network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change… more
- Centene Corporation (Jefferson City, MO)
- …comprehensive marketing strategies specifically tailored to target providers that drive provider network expansion and positive sentiment and provider ... brands. Collaborates with cross-functional teams, including Product, Health Plans, Provider (Value-based Strategies), Network , Medical Affairs/Population Health… more
- Centene Corporation (Topeka, KS)
- …manner, including presentations and education as needed. + Oversees monitoring of SHP provider network database for accuracy and timeliness; makes corrections as ... care experience; Master's degree preferred. Seven to nine years extensive provider network management/health care management experience. Strong project… more
- IQVIA (Durham, NC)
- …develop innovative, data-driven, and patient-centered solutions for CNS trials. The Medical Strategy Lead will provide senior clinical and scientific expertise ... This Position is Remote in North America The IQVIA CNS Center...Board-Certified physicians to join our team as a Medical Strategy Lead to help us expand our CNS portfolio… more