- Commonwealth Care Alliance (Boston, MA)
- …Contracting **Position Summary:** Under the direction of the Senior Contract Manager, Provider Contracting , the Senior Provider Contract Manager is ... negotiations and management. + Specific background in complex managed care provider contracting including Health Systems, Physician Hospital Organizations,… more
- Commonwealth Care Alliance (Boston, MA)
- …position partners closely with provider engagement, delegation partnerships, provider services, contracting , quality, compliance, medical management, and ... with organizational priorities. - Foster a culture of continuous improvement, professional development, and high performance within the provider relations… more
- Commonwealth Care Alliance (Boston, MA)
- …and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital, behavioral health, ... Provider Network Management staff to ensure an adequate and appropriate provider network When necessary, participate in contracting strategy discussions… more
- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based ... Long-Term Services and Supports (LTSS) provider organizations that serve One Care and Senior Care...metrics. + Collaborate with Business Intelligence, Finance, Quality, and Contracting to develop and disseminate performance reports and dashboards.… more
- Washington Metropolitan Area Transit Authority (Alexandria, VA)
- …candidate must obtain Washington Metropolitan Area Transit Authority (WMATA) Contracting Officer?s Technical Representative (COTR) Certificate within 60 days of ... program such as National Contract Management Association (NCMA), the Certified Professional Contracts Management (CPCM), or an appropriate certificate from a program… more
- Commonwealth Care Alliance (Boston, MA)
- …critical measures. The role supports efforts of the organization's Network and Provider Contracting department and will have regular interaction with relevant ... 011230 CA- Provider Engagement & Performance **Position Summary:** The HEDIS...of HEDIS and Health Plan quality initiatives; familiarity with behavioral health KPIs such as IET and FUH +… more
- Commonwealth Care Alliance (Boston, MA)
- …improving UM program design, policies, procedures, workflows, and correspondence. - Supports provider relations and provider contracting leaders in the ... network strategy, vendor relationship management and claims processing. Works closely with provider relations on resolving provider related issues. - Directs the… more
- Washington Metropolitan Area Transit Authority (Landover, MD)
- Director, Tech & Business Operations Job ID: 250978 Location: MD-8100 Professional Place Full/Part Time: Full-Time Posting Open-Close 10/28/2025 - 11/10/2025 Union ... for directing, managing, supporting and evaluating multi-discipline functions which provide essential technical development support and administrative leadership to… more
- Washington Metropolitan Area Transit Authority (Washington, DC)
- …MARKETING STATEMENT** The Project Delivery Department is seeking an enthusiastic professional to help lead the cross-functional planning and execution of major ... complex construction projects in support of Metro?s overall mission to provide safe, reliable, and affordable transportation options throughout the region. This… more
- Zeiders Enterprises, Inc (Woodbridge, VA)
- …market and competitive research; develop customer and competitor profiles; and provide data-driven recommendations for bid/no-bid decisions. + Identify, develop, and ... including subordinate managers, support consultants, and BD staff). + Provide leadership to cross-functional capture teams, exercising influence without direct… more
- CVS Health (Columbus, OH)
- …of 3 years work experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. + Proven working ... and executes complex Medicaid contracts with health systems, physician groups, and behavioral health providers in accordance with company standards to maintain and… more
- Elevance Health (Sacramento, CA)
- ** Behavioral Health Community Partnership Manager** **(Behaioral Health Provider Quality Manager)** **Sign on Bonus: $2,500** **Candidates must posses a ... insightful analytics to improve the delivery of care. The ** Provider Quality Manager** is responsible for leading Behavioral...face to face, telephonically, and via Web-Ex to support provider training on Carelon processes, contracting /… more
- Molina Healthcare (Reno, NV)
- …BHT treatment plans to evaluate effectiveness and treatment efficacy. * Collaborates with provider contracting and providers services to support recruitment and ... procedures. * Works collaboratively with the utilization and care management departments to provide ABA and behavioral health therapy (BHT) services to Molina… more
- Commonwealth Care Alliance (Boston, MA)
- …position partners closely with provider engagement, delegation partnerships, provider services, contracting , quality, compliance, medical management, and ... with organizational priorities. * Foster a culture of continuous improvement, professional development, and high performance within the provider relations… more
- Elevance Health (Tampa, FL)
- **Health Services Director- Carelon Behavioral Health** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... Director** is responsible for clinical licensing, enterprise clinical license contracting , denial rationale, auditing, compliance reporting and overall direction for… more
- The Cigna Group (Bloomfield, CT)
- …Analysis, Power View, MS Access, MS Project. + 4+ years in healthcare operations, provider services, or contracting . + Familiarity with provider data ... The Provider Data Manager is a strategic leadership role...+ Foster a culture of accountability, continuous improvement, and professional growth. + Oversee stretch assignments and strategic projects… more
- HonorHealth (AZ)
- …Nurse Practitioner (NP) works collaboratively with members of the healthcare team to provide care appropriate to the age of the patients served on his/her assigned ... Nurse (APN), the NP will demonstrate leadership as a mentor, educator, researcher and provider . The NP adheres to and functions within the scope of practice defined… more
- CenterWell (Austin, TX)
- …meeting and exceeding goals, and requires an understanding of value-based agreements and provider contracting . The MSO Channel Development Lead will be the ... negotiations, providing key insights that advance agreements with new provider partners + Provide national and local...five years experience in provider network development, provider engagement and/or provider contracting … more
- Highmark Health (Oklahoma City, OK)
- …cross organizational programs and projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2 years Understanding of ... to drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark… more
- State of Colorado (Denver, CO)
- …and continuous monitoring of the 988 contract with the statewide contact center provider . The role requires deep knowledge of the statewide behavioral health ... performance improvement plans as needed. + Determining whether corrective or contracting actions should be pursued based on non-compliance, in coordination with… more
