- ARCO (Cincinnati, OH)
- …career. **WHAT WE CAN OFFER YOU** At ARCO, we are committed to taking care of our greatest asset - our team. ARCO's best-in-class benefits and superior compensation ... and administrative aspects of data center projects, including estimating, contract negotiations, proposal preparation, planning, scheduling, budgeting, procurement, and… more
- Elevance Health (Mason, OH)
- ** Provider Contract / Cost of Care Consultant Senior** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration ... an accommodation is granted as required by law. The ** Provider Contract / Cost of Care...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- Elevance Health (Mason, OH)
- …office. **Position Overview:** Provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses ... develop contracting strategy and supports all aspects of the contract negotiation process. Works with multiple provider ...modifications as applicable + Recommends standardized practices to optimize cost of care + Educates provider… more
- Molina Healthcare (Covington, KY)
- …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
- Elevance Health (Cincinnati, OH)
- Provider Success Consultant Sr. (Ohio Market) **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... This position will require the candidate to travel to provider locations in Ohio at a minimum of 50%...at a minimum of 50% of the time. **The Care Consultant Sr.** is responsible for fostering long-term partnerships… more
- Molina Healthcare (Covington, KY)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Cincinnati, OH)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- Molina Healthcare (Covington, KY)
- …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
- Molina Healthcare (Covington, KY)
- …claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and ... cost containment reports and makes recommendations based on relevant...materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of… more
- Molina Healthcare (Cincinnati, OH)
- …other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) + ... Builds work breakdown structures, monitors task activities, and ensures state contract timelines are met. Monitors the project from inception through delivery.… more
- Molina Healthcare (Covington, KY)
- …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more
- Molina Healthcare (Covington, KY)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... JOB DESCRIPTION Job Summary Provides support for care management/ care coordination long-term services and...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
- Elevance Health (Mason, OH)
- **Behavioral Health - Care Manager II** **Location** : _Virtual:_ This role enables associate to work virtually full-time, with the exception of required in-person ... granted as required by law. The **Behavioral Health - Care Manager II** is responsible for managing psychiatric and...access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines… more
- Molina Healthcare (Covington, KY)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. * Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Molina Healthcare (Covington, KY)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. + Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- ADM (Erlanger, KY)
- …The Performance Manager is responsible for the performance of the services by Service Provider /s. A functional subject matter expert, as well as an expert in the ... This role will interact closely with the ITSM Governance peers ( Contract , Financial, Service Owners) and Service Delivery Managers. **Primary Responsibilities** +… more
- Deloitte (Cincinnati, OH)
- …and advisory services, covering areas such as valuation modeling, cost optimization, restructuring, business design and transformation, infrastructure and real ... employment of data, and delivery of products and services that embrace new care models. They advise both corporate and private equity buyers with M&A transactions… more
- City of Cincinnati (Cincinnati, OH)
- …Participates in the development and administration of assigned program budget. Create cost estimates and other contract documents. Identify and apply for ... phases of multiple projects.? Check construction plans, design calculations, or cost estimations to ensure completeness, accuracy, or conformity to engineering… more
- ADM (Erlanger, KY)
- …performance, service, and quality. + Lead strategic negotiations, supplier selection, and contract management. + Track industry trends and cost drivers to ... and compliance. + Utilize spend analysis, supplier performance tools, and contract management systems. + Drive continuous improvement and innovation within the… more
- Elevance Health (Mason, OH)
- …more complex medical transplant issues. + Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... member access to medically necessary, quality healthcare in a cost effective setting according to contract . +...and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management… more
