- Elevance Health (Richmond, VA)
- The Cost of Care Mgr leads and manages...acumen. + 2 years experience in broad-based analytical, managed care payor or provider environment as well as ... multiple cost of care initiatives enterprise wide (eg local, within each state,... improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual… more
- Sedgwick (Richmond, VA)
- …negotiate fee-for-service ancillary contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and ... Taking care of people is at the heart of...or university preferred. **Experience** Four (4) years of progressive provider network contract negotiation experience or equivalent… more
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... people in mind, body and spirit through exceptional patient care . Success in this goal requires a culture of...a member of the BSMH Legal Network, Senior Paralegal/GPO Contract Administrator has two roles: (1) supports attorneys in… more
- CBRE (Richmond, VA)
- …basis and present these reports. Align cost plan with project master schedule; provide cost guidance and direction to achieve cost goals with ... costing of LEED/sustainability initiatives (as appropriate). + Review all invoices against cost plan; provide valuation services and signoff to project team… more
- Humana (Richmond, VA)
- …completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns. ... Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes, as needed. Understands department, segment, and… more
- Sharecare, Inc. (Richmond, VA)
- …-effective manner while ensuring high quality care . The RN coordinates with the Primary Care Provider and all other members of the health care team to ... increasing acuity, and for intervening with the participants and their Primary Care Provider according to the disease management program intervention guidelines.… more
- Option Care Health (Richmond, VA)
- …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
- Elevance Health (Richmond, VA)
- …cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. + The process does not involve clinical ... The **Foster Care Managed Case Manager** is responsible for overall...of position, as required by applicable state law and contract . **How you will make an impact:** + Working… more
- Elevance Health (Richmond, VA)
- …needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract . ... + Will serve as a resource to other BH Care Managers. Assists with more complex cases and may...or any combination of education and experience which would provide an equivalent background. + Current active unrestricted license… more
- IMSolutions, LLC (Richmond, VA)
- …to work at the agency's office in Washington, DC._** As a **Federal Contract Specialist** , you provide acquisition support services, including contract ... and contract closeouts. + Market research/analysis, selection and administration of contract terms and conditions, cost , and price analysis. + US Citizenship… more
- HCA Healthcare (Richmond, VA)
- …+ 10 years of relevant experience is required. Strongly prefer experience with Managed Care contract negotiation for either a hospital or MCO. **HCA Healthcare ... ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care , uninsured discounts, and other… more
- Federal Reserve System (Richmond, VA)
- …identify and report disparities, and research relevant information. + Perform price/ cost analysis and contract administration tasks. + Collaborate across ... our communities. Bring your passion and expertise, and we'll provide the opportunities that will challenge you and propel...includes tuition assistance, generous paid time off, top-notch health care benefits, child and family care leave,… more
- CVS Health (Richmond, VA)
- …systems). Drives 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
- Prime Therapeutics (Richmond, VA)
- …satisfaction. Develops and tracks the appropriate metrics to monitor the quality and care cost impact of the client's program. Requires communication across all ... empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more
- Sedgwick (Richmond, VA)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... To analyze complex or technically difficult surety and surety bond claims; to provide resolution of highly complex nature and/or high exposure surety claims; to… more
- Prime Therapeutics (Richmond, VA)
- …outcomes. Develops and tracks the appropriate metrics to monitor the quality and care cost impact of client programs. Requires coordination and communication ... and analysis. Demonstrates the value of pharmacy solutions (unit cost , utilization management & patient care enhancements)....achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Highmark Health (Richmond, VA)
- …configurations and onboarding of new plans/providers. Translates configuration rules, fee schedules, contract terms, provider data code sets, and benefits into ... to benefits, business rules, screen design and functionality, templates, workflows, provider contracts, user task analysis, personalization to different plans, and… more
- Elevance Health (Richmond, VA)
- …service coordinator and other clinical healthcare management and interdisciplinary teams to provide care coordination support. + Manages non-clinical needs of ... law and contract requirements. + Experience working with older adults in care management, provider or other capacity, highly preferred. + Experience managing… more
- Prime Therapeutics (Richmond, VA)
- …satisfaction. Develops and tracks the appropriate metrics to monitor the quality and care cost impact of the client`s program(s). Requires communication across ... responsible to serve as the clinical liaison for assigned contract (s). Manages overall client relationship. Participates in the development...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Federal Reserve System (Richmond, VA)
- …across the NPO, leveraging NPO-developed analytics and reporting data to identify trends, contract consolidation and cost savings opportunities. + Serve as an ... our communities. Bring your passion and expertise, and we'll provide the opportunities that will challenge you and propel...includes tuition assistance, generous paid time off, top-notch health care benefits, child and family care leave,… more