- Elevance Health (Mason, OH)
- ** 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 (Mason, OH)
- ** 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
- Elevance Health (Mason, OH)
- ** Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration ... granted as required by law. The ** Provider Contract Cost of Care Analyst...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Molina Healthcare (Covington, KY)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads...department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates.… more
- Molina Healthcare (Covington, KY)
- …in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of individual provider and ... negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost... provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare… more
- Molina Healthcare (Covington, KY)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Bachelor's Degree or equivalent provider contract , network development and management, or project ... provider service, or claims experience in a managed care setting. * 3+ years experience in managed healthcare... Provider Services. * 3+ years experience in provider contract negotiations in a managed healthcare… more
- Molina Healthcare (Covington, KY)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Cincinnati, OH)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- Elevance Health (Mason, OH)
- …The **Manager Senior Engineering** is responsible for providing analytical support to the Cost of Care and/or Provider Contracting organizations. **How you ... realized and recommends modifications as applicable. + Recommends standardized practices to optimize cost of care . + Educates provider contractors on… more
- Molina Healthcare (Covington, KY)
- …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
- Molina Healthcare (Cincinnati, OH)
- …other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) + ... Builds work breakdown structures, monitors task activities, and ensures state contract timelines are met. Monitors the project from inception through delivery.… more
- Molina Healthcare (Covington, 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 (Covington, 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
- Elevance Health (Mason, OH)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental ... for autism and depression, and insightful analytics to improve the delivery of care . **Virtual** - This role enables associates to work virtually full-time, with the… more
- ADM (Erlanger, KY)
- …The Performance Manager is responsible for the performance of the services by Service Provider /s. A functional subject matter expert, as well as an expert in the ... This role will interact closely with the ITSM Governance peers ( Contract , Financial, Service Owners) and Service Delivery Managers. **Primary Responsibilities** +… more
- Elevance Health (Cincinnati, OH)
- …service coordinator and other clinical healthcare management and interdisciplinary teams to provide care coordination support. + Manages non-clinical needs of ... is responsible for supporting the LTSS Transition Coordinator (or contracted provider ) in contributing to the components of the person-centered planning process,… more
- City of Cincinnati (Cincinnati, OH)
- …Participates in the development and administration of assigned program budget. Create cost estimates and other contract documents. Identify and apply for ... phases of multiple projects.? Check construction plans, design calculations, or cost estimations to ensure completeness, accuracy, or conformity to engineering… more
- City of Cincinnati (Cincinnati, OH)
- …Participates in the development and administration of assigned program budget. Create cost estimates and other contract documents. Identify and apply for ... phases of multiple projects.? Check construction plans, design calculations, or cost estimations to ensure completeness, accuracy, or conformity to engineering… more
- ADM (Erlanger, KY)
- …performance, service, and quality. + Lead strategic negotiations, supplier selection, and contract management. + Track industry trends and cost drivers to ... and compliance. + Utilize spend analysis, supplier performance tools, and contract management systems. + Drive continuous improvement and innovation within the… more
- Bon Secours Mercy Health (Cincinnati, OH)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... Compliance and Revenue Cycle teams, Ensemble, and BSMH physicians and advance care clinicians, to achieve system-wide success in value-based contracts. This is a… more