- Elevance Health (Waukesha, WI)
- ** Cost of Care / Provider Contracting Data Analyst** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... an accommodation is granted as required by law. The ** Cost of Care / Provider Contracting...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Waukesha, WI)
- …for providing the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you will make an impact:** ... cost of care . + Educates provider contractors on contracting analytics from a...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Molina Healthcare (Milwaukee, WI)
- …previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes… more
- Molina Healthcare (Milwaukee, WI)
- …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...departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
- Molina Healthcare (Milwaukee, WI)
- …health plans on the financial impact. * Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Milwaukee, WI)
- …health plans on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- Molina Healthcare (Milwaukee, WI)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... keeps executive leadership apprised. * Leads analysis of medical care cost and utilization data. * Leads...that interface with the segment including medical management, network contracting and provider relations, member services, claims… more
- CDM Smith (Milwaukee, WI)
- … cost estimates and supporting analysis in coordination with government cost estimators and contracting officers. * Participate in pre-construction meetings, ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- Molina Healthcare (Milwaukee, WI)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost -effective based on the severity ... that support ongoing improvements of clinical operations functions and promote quality cost effective health care for Molina members. + Develops initiatives… more
- Molina Healthcare (Milwaukee, WI)
- …etc. **PREFERRED EXPERIENCE:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, ... through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost -efficiency, and continuity of care . + Ensures that… more
- Clarios (Milwaukee, WI)
- …Procurement strategies, including: identifying key suppliers, market influencers on cost , technology opportunities, risks and strategic direction, etc. * Lead ... supply market analysis, supplier analysis, RFI/RFP building, baseline analysis, contracting , outsourcing & offshoring, product lifecycle management, building business… more
- Molina Healthcare (Milwaukee, WI)
- …for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates. + Assist ... interpolation, and other statistical methodologies to predict future trends in cost , utilization, and performance. + Assist with research, development and completion… more