- The Cigna Group (Franklin, TN)
- …member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager . This role assists in developing the strategic direction and ... and practice managers. Has knowledge of contracting process, contract management, network operations, Medicare fee schedules, financial terms, and metrics.… more
- The Cigna Group (Baltimore, MD)
- …leadership including creating and delivering presentations. + Collaborating with Provider Performance Senior Manager / Manager on strategic plans on growth, ... assists in the growth and development of the provider network . The External Representative is the primary conduit to...development, and vision for assigned territory. Participating with the Senior Manager / Manager in monthly financial… more
- CVS Health (Hartford, CT)
- …impact in your next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, ... scale and/or innovative providers as needed to ensure attainment of network expansion and strategic targets.* Collaborate cross-functionally to manage provider… more
- CVS Health (Des Moines, IA)
- …deliver solutions to make health care more personal, convenient and affordable. The Senior Manager negotiates, executes, conducts high level review and analysis, ... and exceeding accessibility, quality and financial goals and cost initiatives. The Senior Manager will be responsible for contracting and implementing fee… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to the Associate Director of Professional Reimbursement Strategy, the Payment Policy and Network Coding Sr. Manager is responsible for leading the research ... align with policies. + Collaborates with Government Regulatory Affairs, Network Management, Medical Economics, Benefit Administration, Provider Services, Audit, IT… more
- Mohawk Valley Health System (Utica, NY)
- Care Manager - Senior Network Health Department: SNH CLINICAL SERVICES Job Summary The Care Manager is responsible for completing a comprehensive ... services that are not a benefit of the plan ( Medicare Services). + Completes comprehensive assessment using the DOH...as requested by the Executive Director or Clinical Services Manager . + Clarifies issues and actively addresses concerns in… more
- CVS Health (Indianapolis, IN)
- …and parameters, or accuracy of provider contract or demographic information. Network Performance/Oversight . Recruits' providers as needed to ensure attainment of ... network expansion and adequacy targets. . Responsible for identifying...knowledge of managed care business, regulatory /legal requirements. . Medicare Advantage knowledge and experience Education Bachelor's degree preferred/specialized… more
- CVS Health (Sacramento, CA)
- …or Mountain time zones - Experience supporting compliance/regulatory activities including network adequacy reporting, network gap mitigation activities and ... experience in West coast region states a plus - Experience in commercial, Medicare and Medicaid lines of business ideal Education Bachelor's Degree or equivalent… more
- St. Luke's University Health Network (Bethlehem, PA)
- …serve, regardless of a patient's ability to pay for health care. The Senior Pharmacy Technician Homestar, under the direction of a pharmacist, delivers medications, ... of any medication or insurance related concerns. + Assists Pharmacy Manager with performing day-to-day activities and administration which may include daily… more
- Aveanna (Atlanta, GA)
- Network , Voice and Collaboration Manager ApplyRefer a FriendBack Job Details Requisition #: 193843 Location: Atlanta, GA 30339 Category: Business Operations ... voice and collaboration configurations, procedures, and troubleshooting guides. Work closely with senior management to align network and voice strategies with… more
- Commonwealth Care Alliance (Boston, MA)
- …and Value Based Care,** the Provider and Facility Quality & Safety Manager is responsible for designing and executing quality measurement and improvement programs ... and is responsible for managing and implementing key population health and network quality initiatives to achieve high performance on CCA's Population Health goals;… more
- WellSense (Boston, MA)
- Nurse Care Manager ( Senior Care Product) - Field Based WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New ... to making a difference in elders' lives. The Care Manager serves a central role on an interdisciplinary team...clinical and assessment skills + Experience with the Medicaid, Medicare , and Senior population + Experience with… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …participant to Information Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry ... and monitor effectiveness of pricing logic. + Provides statistical reports to Network Administration, Medical Management, Marketing and Medicare Advantage to… more
- MetroLink (Los Angeles, CA)
- Senior Engineer, State of Good Repair Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4210771) Apply Senior Engineer, State of Good Repair ... + Benefits + Questions SUMMARY PURPOSE OF POSITION The Senior Engineer, State of Good Repair will be responsible...Engineer, State of Good Repair will be a Project Manager in-charge of delivering Metrolink's portfolio of State of… more
- Humana (Louisville, KY)
- …of providing frameworks to maximize available resources to achieve growth The Medicaid Senior Insurance Product Manager plays a critical role in developing and ... needs of Humana's customers while aligning with its business objectives. The **Medicaid Senior Insurance Product Manager ** plays a critical role in developing… more
- Healthfirst (Bronx, NY)
- …level of independence both at home and within their communities. Education within Medicare , the Medicare Savings Program (MSP), assist our members in applying ... for a longer cycle of work. Working under the direction of the Entitlement Manager and Team Lead, maneuvers multiple tasks independently with a fast paced proactive… more
- Prime Therapeutics (Columbus, OH)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Pharmacist Account Manager - Remote in Raleigh, NC **Job Description ... managing strategic accounts across various lines of business (Managed Medicaid; Commercial; Medicare ; Exchange) under the guidance of the Vice President of Clinical… more
- CareOregon (Portland, OR)
- …Title Senior Clinical Pharmacist Exemption Status Exempt Department Pharmacy Manager Title Director of Pharmacy - Clinical Services Direct Reports n/a ... diversity, and inclusion when framing thoughts and ideas. Job Summary The Senior Pharmacy Clinical Coordinator is responsible for coordinating with staff and… more
- CVS Health (Springfield, IL)
- …implement the Quality and Practice Transformation strategies across the IL provider network , with a focus on alignment of practice operations and capabilities with ... required: RN, Pharmacist, LCSW -3+ years leadership experience in a Medicaid or Medicare managed care setting -3+ years experience within the following areas: HEDIS,… more
- The Cigna Group (Atlanta, GA)
- …Provider Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director, this individual ensures ... local office 3 days per week.** The Provider Performance Senior Advisor is an integral part of a cross-functional,...the effective performance management of the provider network for his/her assigned sub-market and/or provider groups. The… more