- Elevance Health (Atlanta, GA)
- ** 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 (Atlanta, GA)
- …of Care Analyst Senior** provides 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
- Elevance Health (Atlanta, GA)
- …of Care Consultant** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims ... 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
- Elevance Health (Atlanta, GA)
- …Applications i** s responsible for providing analytical support to the Cost of Care and/or Provider Contracting organizations. **How you will make an ... 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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …all line of business. * Oversees national network management and operations provider contracting strategies - identifying specialties and geographic locations to ... including government-sponsored health plans. * Experience with various managed health care provider compensation methodologies, primarily across Medicaid and… more
- Centene Corporation (Atlanta, GA)
- …Two years of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management, or clinical ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- Prime Therapeutics (Atlanta, GA)
- …Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose ... purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven...the future of pharmacy with us. **Job Posting Title** Provider Relations Manager - Remote **Job Description** The Manager… more
- Molina Healthcare (Atlanta, GA)
- …customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed healthcare provider ... negotiating different provider contract types, ie, physician, group and hospital contracting , etc. To all current Molina employees: If you are interested in… more
- Western Digital (Atlanta, GA)
- …supplier performance, resolve issues, and drive improvements in quality, delivery, and cost . + **Negotiation and Contracting :** Lead negotiations with suppliers ... Manages compliance to contracting terms and proactively develops and manages contracting metrics + ** Cost Optimization:** Drive cost -saving initiatives… more
- Highmark Health (Atlanta, GA)
- …Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population health ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2… more
- Humana (Atlanta, GA)
- …us put health first** The IT Vendor Management Lead - EMR, Clinical Care Delivery & Home Health Platforms supports strategic suppliers that underpin clinical ... workflows, care delivery systems, electronic health/medical records (EHR/EMR), and home...accountability. + Manage enterprise financials for assigned suppliers including cost optimization, forecasting, ROI, and long-term investment planning. +… more
- Oracle (Atlanta, GA)
- …time estimates. + Gather, analyze, and document LOE data to prepare accurate project cost estimates for contracting purposes. + ** Contracting & Budgeting:** ... them turn data into lifesaving decisions and better patient care . We want people just as dedicated as we...the capture of the level of effort (LOE) for contracting work. This role will be essential in bridging… more
- Sedgwick (Atlanta, GA)
- …experience required. Experience in a healthcare management environment including provider contracting , servicing and benefit interpretation preferred. **Skills ... medical contracts for multiple lines of business in managed care markets. Grow the network by recruiting new medical...data and financial models. + Prepares, negotiates, and administers provider contracts. + Develops and expands provider … more
- Oracle (Atlanta, GA)
- …clear roles, SLAs, and succession plans. + Chair the Estimate Review Board; provide independent cost assurance for major funding decisions. + Oversee development ... change orders for reasonableness. + Support negotiations with LV and other contractors; provide claim analysis and cost entitlement assessments. + Maintain a… more
- Humana (Atlanta, GA)
- …your skills to make an impact** **Required Qualifications** + 9+ years' healthcare provider contracting experience + 5+ years' experience with developing and/or ... VB provider payment models designed to promote improved quality, outcomes, and cost of care . Primary responsibilities of this role will be the evaluation… more
- Molina Healthcare (Atlanta, GA)
- …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 (Atlanta, GA)
- …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
- Oracle (Atlanta, GA)
- …to market by managing pipeline intake and ensuring seamless engagement during contracting and estimating of Non-Recurring Costs (NRCs) with lease providers. This ... with precision and urgency. As a manager, you will provide strategic and operational leadership for a team of...maintain intake processes that balance speed with rigor. + ** Contracting & NRC Estimation** + Lead engagement with lease… more
- Molina Healthcare (Atlanta, GA)
- …management standardization, and cost -effective quality outcomes in a managed care environment. Contributes to overarching strategy to provide quality and ... for multi-state licensure. 5 years in behavioral health-specific managed care leadership. + Experience with value-based contracting , fraud/waste/abuse… more