- Elevance Health (Louisville, KY)
- ** Provider Contract / Cost of Care Consultant** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and ... 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
- Molina Healthcare (Louisville, KY)
- …supports assigned contracts with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes reports according to ... Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider 's office,… more
- CVS Health (Frankfort, KY)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... and alignment with organizational goals to ensure the delivery of exceptional provider experiences and operational excellence. This role serves as the primary… more
- Molina Healthcare (Louisville, KY)
- …standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost -effective member care . Essential ... related business documents. Required Qualifications * At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more… more
- Molina Healthcare (Louisville, 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 (Louisville, 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 (Louisville, KY)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... health care concerns, uses clinical judgment to provide care management or refer members to...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
- Molina Healthcare (Louisville, KY)
- …to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . **Job Duties** * ... based on needs of the business) **Job Summary** Provides support for care management/ care coordination activities and collaborates with multidisciplinary team… more
- Molina Healthcare (Louisville, 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
- Molina Healthcare (Louisville, 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 (Louisville, 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
- Highmark Health (Frankfort, KY)
- …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
- BrightSpring Health Services (Louisville, KY)
- Our Company Abode Care Partners Overview We are seeking a results-driven and experienced clinical leader to drive provider education, quality improvement, and ... operational excellence across Abode Care Partners. This individual will play a key role...chart reviews and create scalable feedback loops that improve provider performance, documentation accuracy, and clinical quality outcomes. +… more
- Humana (Frankfort, KY)
- …. The case manager will offer guidance, support, and coordination of the beneficiary's care as directed by the beneficiary, the provider (s) or other members of ... needs of TRICARE beneficiaries, to maximize each beneficiary's capacity for self- care , to cost -effectively achieve desired clinical outcomes and to enhance… more
- Louisville/Jefferson County MSD (Louisville, KY)
- …Labor Negotiation Team, attend Board and/or Board Committee meetings and provide reports on assigned cases/projects. Knowledge, Skills and Abilities Necessary to ... the Work Knowledge of contract , employment, labor, personal injury, construction, environmental and/or real...on any of the areas summarized below: Group Health Care Plans: Hospital/Surgical MSD offers its employees and their… more
- CVS Health (Frankfort, KY)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Humana (Frankfort, KY)
- …Professional contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct ... integrity, or healthcare data analytics, preferably within a managed care or payer environment. + Advanced proficiency in data...following systems: CAS, CISpro and CIS + Experience with provider contract payment analysis and knowledge of… more
- UMB Bank (Frankfort, KY)
- …Risk, Compliance, Information Security, Finance, and Business Operations to ensure contract terms meet applicable standards and adequately protect UMB interests. You ... renewals, software license, maintenance, support, subscriptions, and/or other third-party contract commitments. This position reports to the Senior Vice President,… more
- BrightSpring Health Services (Louisville, KY)
- …Company's service lines, including pharmacy, home health care and primary care , and rehabilitation and behavioral health, we provide comprehensive and more ... and want to drive business success while helping patients get compassionate care they need and deserve? Hospice Finance focuses on the organization's financial… more
- Ford Motor Company (Frankfort, KY)
- …Relationship Management: Provide feedback to valued supply partners on their cost position relative to the market to help build effective long-term, productive ... of great Ford and Lincoln vehicles. By partnering with dealerships, we provide financing, personalized service and professional expertise to thousands of dealers and… more