- Elevance Health (Wallingford, CT)
- ** Provider Contract / Cost of Care Analyst Senior-Analytics** **Location:** This position will work a hybrid model (remote and office). Must live within 50 ... dives to uncover root-cause trend drivers and support initiative design for remediation. The ** Provider Contract / Cost of Care Analyst Senior** provides… more
- The Cigna Group (Bloomfield, CT)
- …as needed. + Strong understanding of Provider Contracting & contract negotiations. In-depth understanding of managed care business processes, data, ... a matrix organization + Deep familiarity with health insurance data, including contract structure and methodologies, claims, eligibility, provider and benefit… more
- Prime Therapeutics (Hartford, CT)
- …changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract ... rate/funding changes. + Develops and implements process for monitoring provider contract compliance and performance based ...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Prime Therapeutics (Hartford, CT)
- …changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract ... rate/funding changes. + Develops and implements process for monitoring provider contract compliance and performance based ...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- The Cigna Group (Bloomfield, CT)
- …analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. + Creates and/or oversees ... for the network solution. + Responsible for meeting unit cost targets, while preserving an adequate and marketable network,...experience with larger, more complex integrated delivery systems, managed care , and provider business models. + Team… more
- The Cigna Group (Bloomfield, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- …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)
- …intake process which includes audit and oversight of audit resources of all provider contract /credentialing materials received from provider , provider ... intake process which includes audit and oversight of audit resources of all provider contract /credentialing materials received from provider . Provider … more
- Point32Health (CT)
- …contracts and may actively participate in external provider meetings with Contract Managers. The individual will also provide support for regulatory requests ... a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are… more
- Elevance Health (Wallingford, CT)
- … provider network by managing the implementation of strategies for provider recruitment, contract negotiations, and relationship development for large health ... ** Provider Network Management Director** **Location:** This position will...health systems, affiliated providers and supports value based and cost of care initiatives. **How you will… more
- The Cigna Group (Bloomfield, CT)
- …or equivalent work experience; Master's degree preferred. + **5+ years experience in Provider Contract negotiations, required** + 8+ years of experience in ... WORK LOCATION: REMOTE position The **National Ancillary Medicare Advantage (MA) Provider Contracting Senior Advisor** is a critical contributor to Cigna's enterprise… more
- CVS Health (Hartford, CT)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. **Position Summary** Constructs negotiation, execution,… more
- CVS Health (Hartford, CT)
- …will: + Drive the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. + ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Nuvance Health (Danbury, CT)
- …3.Organizes and analyses physician practice reimbursement, utilizing appropriate rates based on contract structure, place of service, provider and modifiers for ... *Description* Summary: The Managed Care Analyst compiles, validates, and analyzes utilization and...Decision Support systems for all relevant payer plans to provide necessary volume, payment and cost data.… more
- Option Care Health (Hartford, CT)
- …alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly ... resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than...treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through… more
- Nuvance Health (Norwalk, CT)
- …appropriate, in an effort to maximize reimbursement. Reviews and edits Managed Care Contract Language relating to Utilization Management Issues. Ensures severity ... physician practices locations, including The Heart Center, a leading provider of cardiology care . Non-acute care...ELIGIBLE EXTERNAL CANDIDATES* Summary: Ensure that patients receive quality care in the most cost -effective manner and… more
- Hartford HealthCare (Hartford, CT)
- …the organization is supported through data and evidence-based evaluation of cost containment, utilization, standardization and contract compliance opportunities. ... leaders to develop sound business case by integrating multiple sources of data ( cost & clinical). Serves as a subject matter expert to promote and educate… more
- The Cigna Group (Bloomfield, CT)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. +...experience with larger, more complex integrated delivery systems, managed care , and provider business models. + Team… more
- Nuvance Health (Danbury, CT)
- …medical groups and ancillaries) as well as WCHN PHO utilizing financial and cost accounting systems in support of the contract negotiation process. Creates ... *Description* *Summary:* Network wide role is responsible for developing and implementing contract reimbursement models and data reporting in support of the payer… more
- HomeSafe Alliance (Hartford, CT)
- …include but not limited to schedule, delivery, performance, quality, safety, cost control, P&L, Service Provider relationships, and customer satisfaction. ... GHC prime contractor and household goods moving service integrator, we provide earlier visibility into upcoming moves and greater network throughput… more