- St. Luke's University Health Network (Allentown, PA)
- … in the communities we serve, regardless of a patient's ability to pay for health care . The Employee Relations Investigator reviews and investigates all ... commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care… more
- CDPHP (Latham, NY)
- …will work closely with all departments such as Member Services, Claims Operations, Provider Relations , Health Care Network Strategy, Configuration ... required. + Minimum of one (1) year experience in health care claims review and adjudication to...EPO, HDPPO, POS, Self-insured and Government Programs. + Customer relations with additional experience in provider billing… more
- Commonwealth Care Alliance (Boston, MA)
- …of Provider Relations leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care ... provider network operations, education, and performance improvement. The Provider Relations Director reports to the Sr...clinical and population health teams to drive provider engagement in quality improvement and care … more
- Commonwealth Care Alliance (Boston, MA)
- …the team + Managed Care experience (preferably Medicare/Medicaid) + Experience in health plan provider relations + Experience with behavioral health ... relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital, behavioral health , community-based,… more
- McLaren Health Care (Flint, MI)
- We are looking for a Provider Relations Representative II, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned ... subsidiary of McLaren Health Care Corporation and is the parent...with at least two (2) years' experience in managed care claims operations or provider billing functions.… more
- McLaren Health Care (Flint, MI)
- We are looking for a Provider Relations Representative I, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned ... subsidiary of McLaren Health Care Corporation and is the parent...and knowledge of HMO, PPO, TPA, PHO and Managed Care claims operations or provider billing functions.… more
- Commonwealth Care Alliance (Boston, MA)
- …+ 3-5 years + Managed Care experience + Experience in health plan provider relations . **Experience (Desired)** + Medicare/Medicaid experience ... 011230 CA- Provider Engagement & Performance **Position Summary** The Provider Relations Liaison is responsible for cultivating, maintaining and strengthening… more
- Trinity Health (Fresno, CA)
- …growth as strategic participants in the network. The Manager Provider Relations & Development will maintain mutually-developed " Health Plan to Provider ... engagement and commitment to the IPA and Central Valley Health Plan (CVHP). **REQUIREMENTS** 1. Bachelor's degree or an...is required. 2. Four (4) years of experience managing care contracting and provider development is required.… more
- CVS Health (Chicago, IL)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... At CVS Health , we're building a world of health...by vendor and NCQA requirements. + Team Leadership: Manage provider relations staff and oversee day-to-day operations.… more
- WellSense (MA)
- …other providers, facilities and community health centers. Works closely with the Provider Relations Supervisor to identify issues and report trends. Acts as ... through effective business interactions and outreach** + **Works collaboratively with Provider Relations Consultants and Supervisor to develop and update… more
- Molina Healthcare (Saginaw, MI)
- **_ Remote and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...serves as the primary point of contact between Molina Health plan and the Plan's Complex Provider … more
- Northern Light Health (Brewer, ME)
- … Care , Hospice Care , end of life, respite care , Home Health Aide, Skilled Nursing Position Provider Relations Liaison/LSW-CLocation Req ID 83374 ... Northern Light Home Care and Hospice Department: Business Development Position is...Work Schedule: 8:00 AM to 4:30 PM Summary: The Provider Relations Liaison/LSW-C is a sales professional… more
- Molina Healthcare (Cheektowaga, NY)
- …and must live in Erie County, NY _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...to larger groups, such as leaders and management of provider offices (including large multispecialty groups or health… more
- Providence (Eureka, CA)
- …qualifications:** + Bachelor's Degree in Healthcare Management. + 2 years Managed care Provider Relations experience. **Why Join Providence?** Our ... with physicians in a managed care /IPA, Medical group, health plan or MSO environment with Provider Relations or Customer Service experience. + upon… more
- Molina Healthcare (San Francisco, CA)
- …and must live in San Diego County _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...serves as the primary point of contact between Molina Health plan and the for non-complex Provider … more
- Molina Healthcare (Provo, UT)
- **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...**PREFERRED EDUCATION** : Associate's Degree Vocational program in Managed Care or some other health care… more
- CareFirst (Baltimore, MD)
- …Supports network projects and outreach initiatives that must be special handled by Provider Relations in order to mitigate risk to CareFirst, supplement existing ... + Knowledge of managed care industry legislated and regulated requirements, health care financial matters and third-party payment methodologies. + Previous… more
- Pacific Medical Centers (Renton, WA)
- …Qualifications:** + Bachelor's Degree - Healthcare Management. + 2 years - Managed care Provider Relations experience. **Why Join Providence** **?** Our ... group, health plan or MSO environment with Provider Relations or Customer Service experience. **Preferred...focus on delivering our mission to advocate, educate and provide extraordinary care . **About Providence** At Providence,… more
- Centene Corporation (Tempe, AZ)
- …Administration, related field or equivalent experience. 7+ years of provider relations or contracting experience in a managed care or insurance environment, ... fresh perspective on workplace flexibility. **Position Purpose:** Oversee the Provider Relations department including negotiations and administering organization… more
- Rush University Medical Center (Chicago, IL)
- …and procedures. **Required Job Qualifications:** + Bachelor's degree in business, marketing, public relations , communications or health care . + A minimum of ... relationships. The position includes promoting RUMC services and our physicians to health care providers, identifying strategic opportunities for advancing RUMC… more