- 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
- CVS Health (Atlanta, GA)
- …regulatory requirements. **Preferred Qualifications** * Proven working knowledge of value based ( VBC ) and Pay for Performance (P4P) behavioral health contracting ... Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, conduct high-level reviews and… more
- Elevance Health (Atlanta, GA)
- …& create IFB files for EIM jobs. + Validate application functionality and performance for existing benchmarks. + Define and design required configuration changes to ... Workflows, Integration Objects, Siebel Adapters, Web Services, Data Transformation Engine, VBC , DTD, XSD, COM interfaces. + Siebel integration with CTI solution… more