- Elevance Health (Smithfield, RI)
- ** Provider Contract / Cost of Care Analyst Senior-Analytics** **Location:** This position will work a hybrid model (remote and office). Must live within 50 ... dives to uncover root-cause trend drivers and support initiative design for remediation. The ** Provider Contract / Cost of Care Analyst Senior** provides… more
- Prime Therapeutics (Providence, RI)
- …changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract ... rate/funding changes. + Develops and implements process for monitoring provider contract compliance and performance based ...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Prime Therapeutics (Providence, RI)
- …changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract ... rate/funding changes. + Develops and implements process for monitoring provider contract compliance and performance based ...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Elevance Health (Smithfield, RI)
- … provider network by managing the implementation of strategies for provider recruitment, contract negotiations, and relationship development for large health ... ** Provider Network Management Director** **Location:** This position will...health systems, affiliated providers and supports value based and cost of care initiatives. **How you will… more
- CVS Health (Providence, RI)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. **Position Summary** Constructs negotiation, execution,… more
- CVS Health (Providence, RI)
- …will: + Drive the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. + ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Humana (Providence, RI)
- …us put health first** The Delaware Valley ACO (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' ... the program may include rotations through various DVACO departments including Care Coordination, Practice Transformation, Data Analytics, Post-Acute Care and… more
- Humana (Providence, RI)
- …completes a review that includes a full analysis of the medication care plan, investigation of overall utilization, and identification of unusual usage patterns. ... Intervenes and advises patients and providers to promote cost effective utilization and quality patient outcomes, as needed. Understands department, segment, and… more
- HomeSafe Alliance (Providence, RI)
- …include but not limited to schedule, delivery, performance, quality, safety, cost control, P&L, Service Provider relationships, and customer satisfaction. ... GHC prime contractor and household goods moving service integrator, we provide earlier visibility into upcoming moves and greater network throughput… more
- IMSolutions, LLC (Providence, RI)
- …to work at the agency's office in Washington, DC._** As a **Federal Contract Specialist** , you provide acquisition support services, including contract ... and contract closeouts. + Market research/analysis, selection and administration of contract terms and conditions, cost , and price analysis. + US Citizenship… more
- CVS Health (Cumberland, RI)
- …of internal and external database applications. * Familiarity with managed care functions including provider contracting, benefit design, medical management, ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Boys Town (Portsmouth, RI)
- …your job as a Family Teacher. Together each of you will be part of a team that provide care and guidance to boys and girls in need. $20,000 HIRING BONUS! up to ... able to demonstrate the knowledge and skills necessary to provide care , based on physical, psychological, psycho/social,...Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider… more
- Boys Town (Portsmouth, RI)
- …+ Must be able to demonstrate the knowledge and skills necessary to provide care , based on physical, psychological, psycho/social, educational, safety, and ... Provides direct care for at-risk youth in a safe and...Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider… more
- Prime Therapeutics (Providence, RI)
- …of data. + Supports the account management team ensuring revenue goals are met, cost of care and administrative expenses are managed and segment profit targets ... assigned account (s). + Demonstrates a thorough knowledge of Cost of Care and implications internally and...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Prime Therapeutics (Providence, RI)
- …of data. + Supports the account management team ensuring revenue goals are met, cost of care and administrative expenses are managed and segment profit targets ... assigned account (s). + Demonstrates a thorough knowledge of Cost of Care and implications internally and...achievements. We value new ideas and work collaboratively to provide the highest quality of care and… more
- Huron Consulting Group (Providence, RI)
- …clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services ... within a consulting firm setting with a focus on cost of care , workforce management, and/or supply...+ Negotiate with vendors to achieve better pricing and contract terms + Implement inventory management strategies to reduce… more
- Boys Town (Providence, RI)
- …on certain maintenance drugs. Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider . We help our employees ... providing youth and families with therapeutic services. + Attends contract meetings and communicates the special qualities of Boys...into one of the largest national child and family care organizations in the country. With the addition of… more
- Humana (Providence, RI)
- …Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims ... to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in a result-oriented and metrics-driven environment. If you are… more
- Elevance Health (Smithfield, RI)
- …programs. The **Audit and Reimbursement Lead** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and ... Under direction of management, the Audit and Reimbursement Lead will provide technical leadership, supervision and coordination on contractual workload involving the… more
- Sedgwick (Providence, RI)
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our ... benefits due, and manages action plan pursuant to the claim or client contract . + Manages subrogation of claims and negotiates settlements. + Communicates claim… more