- The Cigna Group (Independence, OH)
- …Must reside in the Cleveland or Independence, OH area.** The **Director** **,** ** Provider Contracting Network Management** serves as an integral member of the ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- Elevance Health (Woburn, MA)
- Associate Referral Bonus: $250 Provider Network Manager Sr. - Contract Negotiations (JR151123) **Location:** This role requires associates to be in-office 2 ... Network Manager Sr** . develops the provider network through contract negotiations,...or any combination of education and experience, which would provide an equivalent background. **Preferred Qualifications:** + 3 years… more
- AmeriHealth Caritas (Newtown Square, PA)
- …tools or reports designed to routinely assess and support existing and new provider network management processes, programs, contract performance, and ... lenses that provide event triggered output for monitoring of impending contract changes and provider patterns.; + Effectively prioritizes and communicates… more
- Avera (Minneapolis, MN)
- …have proper documentation to join and remain in the network . + Maintain provider manual and policies and maintain contract database and associated files. + ... Forward for you and our patients. Work where you matter.** **A Brief Overview** The Provider Contract Manager is a critical member of Avera Health Plans (AHP) … more
- Elevance Health (Mason, OH)
- ** Provider Contract /Cost of Care Consultant** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and ... GA, Richmond, VA, Norfolk, VA or Mason, OH. The ** Provider Contract /Cost of Care Consultant** provides analytical...improving the quality of care, and increasing member and provider network satisfaction. Provides expert advice, analytic… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III Job...for the initial on-board training of new managed care contract provider partners, and for ensuring their ... Category: Provider Relations Department: Provider Network Management Location: Los Angeles, CA,...public agency created by the state of California to provide health coverage to low-income Los Angeles County residents.… more
- Elevance Health (Cincinnati, OH)
- … Manager - LTSS & Contracting** is responsible for developing the LTSS provider network through contract negotiations (language and rates), relationship ... health, behavioral health, long term services and supports, and psychosocial needs._ ** Provider Network Manager - LTSS & Contracting** **Location:** This… more
- The Cigna Group (Bloomfield, CT)
- …position aligned to the Connecticut Market. Must live in Connecticut._** The **Contractor, Provider Network Management** serves as an integral member of the ... + Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms. +...lieu of a Bachelor degree.** + **1+ years of Provider Contracting and Negotiating for Healthcare ** **Hospital/… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …in resolution of escalated provider concerns/issues, distribution of workload, and provide peer review for contract accuracy. May develop or improve work ... Lives** Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so...serve through our Healthsource blog: https://healthsource.premera.com/ . As the ** Provider Network Executive III** , you will… more
- AmeriHealth Caritas (Dublin, OH)
- …services. Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Provider Network Account Executive II (AE II) is responsible ... for all products. **Responsibilities:** + Monitor and manage the provider network to ensure service accessibility and... service complaints and negotiate solutions. + Ensure accurate contract loading and submissions and manage network … more
- AmeriHealth Caritas (Detroit, MI)
- …services. Discover more about us at www.amerihealthcaritas.com. **Position Overview:** The Provider Network Account Executive II (AE II) is responsible ... all products. **Key Responsibilities:** + Monitor and manage the provider network to ensure service accessibility and... service complaints and negotiate solutions. + Ensure accurate contract loading and submissions, and manage network … more
- St. Luke's University Health Network (Allentown, PA)
- …include but are not limited to organizing and directing vendor evaluations, contract engagement, and value analysis for IT, RFI/RFPs as required, facilitating asset ... and governance. At an operational level, the Manager directs contract consultations and negotiations, including contract reviews,...and procedures for the VCMO to align with the Network 's and IT objectives + Develop and maintain strong… more
- Sharp HealthCare (San Diego, CA)
- …virtually, and conducts physician, hospital and/or ancillary meetings, as necessary.Ensures provider network meets all regulatory and accreditation requirements ... orientation/training and other resources to educate providers and key provider staff on Plan products, processes, and contract...to ensure the Plan maintains a compliant and adequate provider network . + Network DevelopmentEvaluates… more
- Elevance Health (Middletown, NY)
- …considered. The ** Provider Network Manager Senior** develops the provider network through contract negotiations, relationship development, and ... ** Provider Network Manager Senior** **Location:** _Hybrid1:_...Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers.… more
- AmeriHealth Caritas (Detroit, MI)
- …policies, procedures, and regulatory changes to providers. + Ensure provider network adequacy and compliance with state contract requirements. + Oversee ... of trust, access, and quality care. As a Senior Provider Network Data Analyst, you'll be at...level goals and lead meetings when needed. + Support provider recruitment, contract management, credentialing, and complaint… more
- AmeriHealth Caritas (Manchester, NH)
- …policies are consistent with claim payment methodologies - Maintain provider network adequacy standards to meet the healthcare needs of Plan members ... services. Discover more about us at www.amerihealthcaritas.com . The Director of Provider Network Management will develop and manage all hospital, physician,… more
- Molina Healthcare (Seattle, WA)
- …Director in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of individual ... Washington _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...groups. * 3+ years experience in provider contract negotiations in a managed healthcare setting… more
- Molina Healthcare (Columbus, OH)
- …that positively impact the Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract Specialists on negotiation of individual ... Ohio _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting… more
- CVS Health (Richmond, VA)
- …terms and conditions. + Controls the development and expansion of the company's provider network by evaluating potential network providers, negotiating ... healthcare providers to ensure a comprehensive and high-quality network . + Contributes to optimizing the network 's...A minimum of 10 years professional work experience in provider network management. + A minimum of… more
- Elevance Health (Manchester, NH)
- …The ** Provider Network Manager** is responsible for developing the provider network through contract negotiations (language and rates), relationship ... ** Provider Network Manager** Carelon Behavioral Health...Primary focus of this role is contracting and negotiating contract terms. **How you will make an impact:** +… more
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