- Centene Corporation (Atlanta, GA)
- …Continuously evaluates APP relationships to ensure quality and cost performance meets or exceeds expectation, ensuring optimal functionality and efficiency. ... Achieves company goals through aggressive APP contract management. + Monitors APP performance under risk arrangements for Medicaid and Medicare product lines. +… more
- Molina Healthcare (Atlanta, GA)
- …including analysis of contract opportunities, development of contract terms, and performance reporting. Extracts, analyzes, and synthesizes data from various sources ... to identify risks as well as packaging and delivering the results to senior leadership. **Job Duties** + Perform analysis of historical cost baselines. + Oversee the development of contract terms and document assumptions. + Design and perform actuarial studies… more
- Centene Corporation (Atlanta, GA)
- …Purpose:** Collaborate with healthcare providers to help them achieve high performance with their value based contracts. + Build collaborative relationships with ... clinical outcomes + Participate in internal and externa customer meetings with providers, VBC team and internal PHCO clinical team + Participate in Joint Operating… more
- CVS Health (Atlanta, GA)
- …barriers, and opportunities and presents results of improvement efforts and ongoing performance measures to plan management . In partnership with business owners, ... + Current competitive ranking by plan + Rate of VBC assigned members covered by QM staff + Rate...achievement + P4P opportunity achievement by plan + Aggregative Performance Improvement Projects meeting "pass" criteria Performance … more