- Elevance Health (Indianapolis, IN)
- …promoting a dynamic and adaptable workplace. Alternate locations may be considered. The ** Provider Contract / Cost of Care Consultant Senior** provides ... the highest level of analytical support to the Cost of Care and/or Provider ...develop contracting strategy and supports all aspects of the contract negotiation process. Works with multiple provider … more
- Elevance Health (Richmond, VA)
- ** Provider Cost of Care Analyst Senior**...to Medical Directors, contract negotiators and management on cost of care issues to help reduce costs ... and adaptable workplace. Alternate locations may be considered. The ** Provider Cost of Care Analyst...from a financial impact perspective. + May recommend alternative contract language and may go on-site to provider… more
- UNC Health Care (Apex, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high quality, cost effective care to patients within ... problem-solving, decision-making, and evaluating clinical/system issues and models of care . Leads interdisciplinary teams to provide integrated delivery… more
- Henry Ford Health System (Troy, MI)
- …improvement initiatives (eg leakage avoidance) and member growth. The Senior Provider Contract Administrator (SPCA) will be responsible for supporting ... or APMEs) which reward providers for managing the total cost of care (TCOC), quality (eg MA...includes the Director, the SPCA and one or more Provider Services Administrators. Contract support will include… more
- Avera (Minneapolis, MN)
- …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) ... implementation of broad based, tiered, and narrow network products and value-based contract arrangements. Also lead medical cost reduction programs to identify… more
- The Cigna Group (Lenexa, KS)
- …to the Kansas City Market. Must live in the Kansas City area._** The **Manager, Provider Contract Management** serves as an integral member of the Provider ... cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative...reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +… more
- The Cigna Group (Independence, OH)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team… more
- CVS Health (Hartford, CT)
- …it all with heart, every single day. We are seeking a **Senior Manager of Provider Contract & Pricing Testing** to join our expanding Testing Center of ... experience managing quality assurance projects. + 5+ years of experience in provider contract testing, claims adjudication systems, quality assurance, or related… more
- CVS Health (Juneau, AK)
- …claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. **Required Qualifications** + 3+ years ... Expert support for questions related to recruitment initiatives, contracting, provider issues/resolutions, related systems and information contained Provide … more
- CVS Health (Sacramento, CA)
- …contracting, provider issues/resolutions, related systems and information contained + Provide guidance and share expertise to others on the team + Understanding ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Centene Corporation (Providence, RI)
- …risk, shared savings, and global capitation. + Analyze provider performance against contract benchmarks (eg, total cost of care , Stars measures) and ... Dual Eligible Special Needs Plans (D-SNPs). This role is critical in analyzing provider performance, modeling contract terms, and generating insights to guide… more
- UNC Health Care (Raleigh, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high quality, cost effective care to patients within ... the health and well-being of the unique communities we serve. Join our growing UNC Urgent Care provider team! This is an employed position with UNC Rex and is a… more
- Molina Healthcare (Rochester, NY)
- …or other health care environment. * 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating ... Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with...5-7 years contract -related experience in the health care field including, but not limited to, provider… more
- CVS Health (Raleigh, NC)
- …to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. + Negotiates settlements as needed. ... contract negotiator: + Negotiates competitive contracts with health care providers using pre-determined internal guidelines and financial standards. + Negotiates… more
- UNC Health Care (Butner, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... problem-solving, decision-making, and evaluating clinical/system issues and models of care . Leads interdisciplinary teams to provide integrated delivery… more
- HCA Healthcare (Nashville, TN)
- …including product features, comparisons, operational impact, future pipelines, FDA filings, cost drivers, and market dynamics. Contract Terms and Conditions: ... **Introduction** Do you have the career opportunities as a Contract Director you want with your current employer? We...join HealthTrust which is part of the nation's leading provider of healthcare services, HCA Healthcare. We are seeking… more
- Corewell Health (Grand Rapids, MI)
- …through execution, compliance and renewal. Provides support for management of medical cost of care and efficiency initiatives. Additionally, this position ... and training to less experienced Specialists. Essential Functions + Manages the contract development and negotiations process for provider networks initiatives.… more
- Molina Healthcare (Seattle, WA)
- …in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of individual provider and ... negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost... provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare… more
- Corewell Health (Grand Rapids, MI)
- …customers) as needed in negotiation decisions impacting legal or regulatory requirements, contract standards, cost targets and payment and pricing methodologies. ... external customers. The successful candidate will understand the nuances of managed care contracting, analytics, managed care payers, delivery system's primarily… more
- Molina Healthcare (Fort Worth, TX)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads...department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates.… more