- Elevance Health (Richmond, VA)
- ** 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 (Richmond, VA)
- ** Provider Contract Cost of Care Consultant - VBC** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consultant...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- The Cigna Group (Richmond, VA)
- …improve total medical cost and quality. + Drives change with external provider partners by offering consultative expertise to assist with total medical cost ... + Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms. +...managing relationships + Understanding and experience with hospital, managed care , and provider business models a plus… more
- The Cigna Group (Richmond, VA)
- …total medical cost and quality. + Drive change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... to the development of alternative network initiatives. Support and provide direction to develop network analytics required for the...and project the financial impact of larger or complex provider contracts and alternate contract terms. +… more
- Humana (Richmond, VA)
- …Professional contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct ... or more years work experience reading and interpreting claims within a managed care /health care environment + Familiarity with Medicaid contracts, claims, and/or… more
- The Cigna Group (Richmond, VA)
- …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
- Highmark Health (Richmond, VA)
- …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
- CVS Health (Richmond, VA)
- …for VBC contracts, working with both internal and external partners, to provide medical cost and outcomes focused analytical research, financial modeling, ... against business and team objectives + Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets… more
- Humana (Richmond, VA)
- …. 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
- CVS Health (Richmond, VA)
- …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
- CVS Health (Richmond, VA)
- …will manage a team of software developers responsible for applications that process provider demographic, contract , and pricing information which is crucial in ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- UMB Bank (Richmond, VA)
- …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
- Humana (Richmond, VA)
- …Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims ... coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are… more
- Evolent (Richmond, VA)
- …years of professional experience in claims-based healthcare analytics with a payer, provider , clinical vendor, managed care , or related healthcare consulting ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Bon Secours Mercy Health (Midlothian, VA)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... and confidential matters effectively. Able to express opinions openly and honestly and provide feedback in a timely and productive manner. Ability to examine and… more
- Generac Power Systems (Richmond, VA)
- …customer expectations by directing the site management team, design team, contract administration, construction accounting, and others as required. Works directly ... management of a project's design, procurement, and construction, including cost , schedule, and quality control. Coordinates all team bandwidth requirements… more
- CVS Health (Richmond, VA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... within the ServiceNow platform, including requisitioning, purchasing, vendor management, and contract management. + Define and communicate the long-term vision and… more
- Humana (Richmond, VA)
- …Partner with IT, Legal, Finance, and business partners to ensure timely, cost -effective renewals. + Negotiate with suppliers to secure favorable terms, pricing, and ... manage upcoming renewals. + Analyze software usage, licensing models, and contract terms to identify optimization opportunities. + Ensure adherence to internal… more
- CDM Smith (Richmond, VA)
- …federal background check. * Knowledge of design review, construction administration, cost estimating, scheduling, and contract management. * Demonstrates ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- Prime Therapeutics (Richmond, VA)
- …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 ... is responsible for performing multifaceted financial analyses to assess manufacturer contract performance, plan performance and to develop rebate estimates related… more