- Molina Healthcare (Bowling Green, KY)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Bowling Green, KY)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Bowling Green, KY)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (Bowling Green, KY)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Molina Healthcare (Bowling Green, KY)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This role negotiates assigned… more
- Molina Healthcare (Bowling Green, KY)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Bowling Green, KY)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- HCA Healthcare (Bowling Green, KY)
- …flexible scheduling + Occurrence based malpractice Insurance + Expert practice management including privileging, provider enrollment, and billing and collections ... ICC (Intensive Care Consortium) is seeking an Intensivist Medical Director to lead the TriStar Greenview Regional Hospital ICU...to test and implement new models of care and management for the best interest of our patients and… more
- Molina Healthcare (Bowling Green, KY)
- …the Network Operating Center (NOC) and Enterprise Business Continuity Management (EBCM) Team. This role is primarily responsible for Disaster Recovery activities ... **Job Description** **Job Summary** The Director of Disaster Recovery (DR) will oversee and...Cloud, disaster recovery, business continuity, team leadership, and project management . + Strong knowledge of application, network ,… more
- Molina Healthcare (Bowling Green, KY)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more
- Molina Healthcare (Bowling Green, KY)
- …care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Determines ... health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more