- Elevance Health (Richmond, VA)
- ** 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 (Richmond, VA)
- ** 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 (Richmond, VA)
- ** Provider Contract Cost of Care Consultant - VBC** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consultant...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- The Cigna Group (Richmond, VA)
- …improve total medical cost and quality. + Drives change with external provider partners by offering consultative expertise to assist with total medical cost ... + Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms. +...managing relationships + Understanding and experience with hospital, managed care , and provider business models a plus… more
- The Cigna Group (Richmond, VA)
- …total medical cost and quality. + Drive change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... to the development of alternative network initiatives. Support and provide direction to develop network analytics required for the...and project the financial impact of larger or complex provider contracts and alternate contract terms. +… more
- CVS Health (Richmond, VA)
- …to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved. + Supports or assists ... design, contract language, service, claims or compensation issues, and provider education needs. + Optimizes interactions with assigned providers and internal… more
- The Cigna Group (Richmond, VA)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team… more
- Humana (Richmond, VA)
- … efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration. The RVP ... and maintain trusted relationships with CMOs and senior executive/clinical leaders at provider and care delivery partner organizations. First and foremost, this… more
- Intermountain Health (Richmond, VA)
- …in care . Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved ... and training techniques. Based on medical record metrics and contract obligations, conducts patient outreach and follow up in...the efforts of providers and practice teams on office-based care delivery interventions resulting in cost of… more
- Highmark Health (Richmond, VA)
- …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
- Elevance Health (Richmond, VA)
- …unless an accommodation is granted as required by law The **Behavioral Health Care Manager II - Virginia** is responsible for managing psychiatric and substance ... needs to ensure access to medically necessary, quality behavioral healthcare in a cost -effective setting in accordance with UM Clinical Guidelines and contract .… more
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... effectively. Able to express opinions openly and honestly and provide feedback in a timely and productive manner. Ability...**Human Resources:** + Ensures scheduling of staff to promote provider productivity as well as promote quality care… more
- UMB Bank (Richmond, VA)
- …Risk, Compliance, Information Security, Finance, and Business Operations to ensure contract terms meet applicable standards and adequately protect UMB interests. You ... renewals, software license, maintenance, support, subscriptions, and/or other third-party contract commitments. This position reports to the Senior Vice President,… more
- Humana (Richmond, VA)
- …with internal stakeholders including Finance, Actuarial, Clinical, Medicare Risk Adjustment, Provider Contracting, and Provider Engagement internally + Leverages ... financial and operational performance for the region + Leads membership, financial, cost & utilization reporting at all levels + Supports Humana's Medicare Advantage… more
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... Purpose of Position** Provides in-person guidance and support to the providers, care teams, and affiliates in clinical integration initiatives that supports the… more
- Humana (Richmond, VA)
- …Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims ... coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are… more
- Evolent (Richmond, VA)
- …years of professional experience in claims-based healthcare analytics with a payer, provider , clinical vendor, managed care , or related healthcare consulting ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Elevance Health (Richmond, VA)
- …more complex medical transplant issues. + Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient ... member access to medically necessary, quality healthcare in a cost effective setting according to contract . +...and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management… more
- Bon Secours Mercy Health (Midlothian, VA)
- At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... of all people in mind, body, and spirit through exceptional patient care . Success in this goal requires a culture of compassion, collaboration, excellence,… more
- Generac Power Systems (Richmond, VA)
- …customer expectations by directing the site management team, design team, contract administration, construction accounting, and others as required. Works directly ... management of a project's design, procurement, and construction, including cost , schedule, and quality control. Coordinates all team bandwidth requirements… more