- Humana (Providence, RI)
- …and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts. ... The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of… more
- CVS Health (Providence, RI)
- …to achieve contracting targets and manage medical costs through effective provider contracting . * Optimize interaction with assigned providers and internal ... strategic, traditional contracts and value-based relationships. Role is for national behavioral health contracting and strategic partnerships** Key deliverables… more
- Highmark Health (Providence, RI)
- … professional billing, facility Patient Financial Services, HIM, Internal Audit, Professional /Facility Reimbursement or Provider Contracting **LICENSES or ... **ESSENTIAL RESPONSIBILITIES** + Performs investigations into potential and existing provider and member fraud, waste and abuse activities.Identifies parties… more
- CenterWell (Providence, RI)
- …our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate ... network management, and payment frameworks (eg capitation, partial risk, direct contracting ) + Population health minded physician with an understanding of, and… more
- Hartford HealthCare (Willimantic, CT)
- …and tranquil setting. The Medical Navigator will work with and assist other professional , clinical, and medical staff in providing day-to-day basic patient care to ... to the rules and regulations for clients at Rushford. Provide basic counseling to help decrease the client anxiety...8. Serves as a liaison between Rushford and outside contracting services, providing prompt service for all requests. 9.… more