- 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)
- …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
- 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
- Elevance Health (Boone, NC)
- …limited to working with providers and internal teams to ensure timely provider contracting , education on specialty topics, developing value-based payment ... shared priorities and strategic visions. Primary duties include: + Assist with provider contracting efforts + Assist with implementing incentives and value-based… 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
- 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
- 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
- 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
- Henry Ford Health System (Troy, MI)
- …responsible professional capacity, with at least one (1) year of payor contracting , provider relations or provider reimbursement experience. + Knowledge ... and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units. 1. Independently...revisions with Payors. 2. Assist in developing Value Based contracting guidelines and take lead role in negotiating Value… more
- Elevance Health (Atlanta, GA)
- …data. + Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies. + Mentors, ... law. The **Network Education Representative** supports and maintains current provider network through customer service including training, credentialing assistance,… more
- HCA Healthcare (Nashville, TN)
- …for you to join HealthTrust which is part of the nation's leading provider of healthcare services, HCA Healthcare. **Benefits** HealthTrust offers a total rewards ... at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical… more
- State of Colorado (Denver, CO)
- …are subject to change. This position is a leadership role within the Behavioral Health Administration (BHA), overseeing both the Contracts Team and the Procurement ... as well as the infrastructure that supports the work. Procurement and Contracting Functions of the BHA The position provides leadership on procurement procedures… more
- HCA Healthcare (Brentwood, TN)
- …analysis and deep dives into data as appropriate to support negotiation strategy and provide value to our contracting partners. + Assist in the design, ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...performance of advanced ad hoc analyses partnering with Payer Contracting & Alignment in creating payer contracts to ensure… more
- BrightSpring Health Services (Nashville, TN)
- …lines, including pharmacy, home health care and primary care, and rehabilitation and behavioral health, we provide comprehensive and more integrated care and ... resolving billing-related issues. This position will work in collaboration with Contracting , Field Branch Operations, Credentialing, and central functions at Support… more
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