- Elevance Health (Louisville, KY)
- ** 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
- Molina Healthcare (Louisville, 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
- Centene Corporation (Frankfort, KY)
- …account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. + Serve ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- CVS Health (Frankfort, KY)
- …to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic information + Coaches more junior colleagues in ... while meeting and exceeding accessibility, compliance, quality, and financial goals and cost incentives + Manages contract performance in support of network… more
- CVS Health (Frankfort, KY)
- …Aetna's National Provider business. This role maintains and updates provider demographic and contract information, including contractually sensitive or ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Option Care Health (Frankfort, KY)
- …us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care , so we are investing in a culture that ... infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality...resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than… more
- GE Appliances, a Haier company (Louisville, KY)
- …of home innovation. As the Commodity Sourcing Senior Manager for Clothes Care & Kitchen Clean-Up, you'll lead sourcing strategies for finished products representing ... spend. In this highly visible role, you will shape supplier partnerships, drive cost competitiveness, and ensure long-term supply chain resilience. You'll serve as a… more
- Molina Healthcare (Louisville, 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 (Louisville, 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 (Louisville, 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
- Molina Healthcare (Louisville, KY)
- …to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . **Job Duties** * ... based on needs of the business) **Job Summary** Provides support for care management/ care coordination activities and collaborates with multidisciplinary team… more
- Molina Healthcare (Louisville, KY)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... JOB DESCRIPTION Job Summary Provides support for care management/ care coordination long-term services and...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
- Molina Healthcare (Louisville, KY)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. * Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Molina Healthcare (Louisville, KY)
- …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. + Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
- Highmark Health (Frankfort, KY)
- …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
- CVS Health (Frankfort, KY)
- …metrics, and establishing long-term strategies to promote the quality of pharmaceutical care in a cost -effective manner to establish a competitive advantage ... updates, medication utilization review, prior authorization processes in alignment with contract , and implementing cost -effective drug utilization initiatives. +… more
- BrightSpring Health Services (Louisville, KY)
- Our Company Abode Care Partners Overview We are seeking a results-driven and experienced clinical leader to drive provider education, quality improvement, and ... operational excellence across Abode Care Partners. This individual will play a key role...chart reviews and create scalable feedback loops that improve provider performance, documentation accuracy, and clinical quality outcomes. +… more
- Louisville/Jefferson County MSD (Louisville, KY)
- …Labor Negotiation Team, attend Board and/or Board Committee meetings and provide reports on assigned cases/projects. Knowledge, Skills and Abilities Necessary to ... the Work Knowledge of contract , employment, labor, personal injury, construction, environmental and/or real...on any of the areas summarized below: Group Health Care Plans: Hospital/Surgical MSD offers its employees and their… more
- CVS Health (Frankfort, KY)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- UMB Bank (Frankfort, KY)
- …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