- Molina Healthcare (Akron, OH)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Akron, OH)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- The Cigna Group (Independence, OH)
- …reside in the Cleveland or Independence, OH area.** The ** Director ** **,** ** Provider Contracting Network Management ** serves as an integral member of ... management of the day to day contracting and network management activities for a local given...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- Molina Healthcare (Akron, OH)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (Akron, OH)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Molina Healthcare (Akron, OH)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Akron, OH)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- BAYADA Home Health Care (Cuyahoga Falls, OH)
- …currently seeking an experienced health care manager to fill the position of **Associate Director ** in our Cuyahoga, OH Senior Living office. Are you looking for an ... care to our clients. **Responsibilities:** + Fully responsible for the management and services including budgeting, planning, recruiting and fiscal management… more
- Bellefaire JCB (Medina, OH)
- …out "Bellefaire JCB: Join Our Team" (https://vimeo.com/894121531) on Vimeo! SUMMARY: The Director of Medina Programs will oversee all aspects of service delivery and ... program staff in all aspects of daily operations including case management , individual counseling, school-based services, home based services, consultation and… more
- Molina Healthcare (Akron, OH)
- …+ Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation ... provider and routine ancillary contracts. + Evaluates provider network and implement strategic plans with...models. Seeks input on new reimbursement models from Corporate Network Management and legal. + Educates internal… more
- Sanofi Group (Akron, OH)
- **Job Title:** Regional Business Director , Mideast **Location:** US Remote **About the Job** Regional Business Directors (RBDs) are key members of the national sales ... serve as strategic leaders and collaborate closely with partners across Account Management , CPE, Marketing, Medical, and Patient Support Services to ensure the… more
- Molina Healthcare (Akron, OH)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, ... Strategy and Services. **Job Duties** + Lead Program Director team, managing all aspects of team's mission and...Responsible for the continued development and enhancement of the Provider Network Management and Operations… more
- Elevance Health (Seven Hills, OH)
- Medical Management Clinician Associate - 40 hours, 4-5 days/week, Saturdays and Sundays **Location:** This role enables associates to work virtually full-time, with ... may be 12 hrs, 10 hours, or 8 hours. The **Medical Management Clinician Associate** responsible for ensuring appropriate, consistent administration of plan benefits… more
- Amergis (Independence, OH)
- …communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based ... healthcare programs, local insurance payors, physician groups, and case management groups. The Business Development Manager manages with an...features, and benefits of the company as a healthcare provider . + Develops a minimum of 10 pursuit plan… more
- Amergis (Independence, OH)
- …communities by connectingpeople to the work that matters since 1988. We provide meaningful opportunitiesto our extensive network of healthcare and school-based ... within 24 hours of receipt (excluding weekends). Communicates with the Assistant Director of Coding Services for assistance when needed Participates in calls with… more
- Cleveland Clinic (Canton, OH)
- …Canton, Plain Township and Tuscarawas County. Mercy also has a growing hospital-owned provider network - Mercy Professional Care Corporation - that offers ... in all aspects of Breast Surgery including both benign and malignant disease management . The ideal candidate will have advanced surgical procedures such as nipple… more
- PNC (Strongsville, OH)
- …Urgency" in facilitating and gaining prompt incident resolution. * The ability to network , influence and manage across all management and organization levels as ... well as cultural boundaries without having direct management authority. * Ability to provide analysis...improvement. You will report to a Technology Enterprise Infrastructure Director . **Job Description** + Provides solutions for IT and… more