- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA- Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with ... and drive both program-wide and provider -specific performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation… more
- Commonwealth Care Alliance (Boston, MA)
- …preferred. - 1+ years of experience in LTSS , social work, provider relations, healthcare communications, project management, or network management within a ... have direct reports. Essential Duties & Responsibilities: - Support LTSS network program operations o Developing agendas,...support o Link with CCA's Business Intelligence team and Provider Engagement Analytics Manager to request reports… more
- Commonwealth Care Alliance (Boston, MA)
- …contracting, quality, compliance, medical management, and analytics teams to advance provider network operations, education, and performance improvement. The ... monitor network performance against internal and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Prioritize and organize own work to meet deadlines + Work collaboratively with Provider Network Management staff to ensure an adequate and appropriate ... the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + Lead...provider network When necessary, participate in contracting… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the ... the implementation of CCA's model of care and strategic objectives. The Manager leads performance evaluation and improvement efforts, including reporting and data… more
- Commonwealth Care Alliance (Springfield, MA)
- …mental illness (SPMI) + Occasional long-term bridge therapy for members awaiting network referral for Behavioral Health Provider + Support in identifying, ... promote hospital avoidance and readmission reduction. Additionally, the SBHC will provide ongoing bridge therapy, urgent visits, crisis intervention, and promote… more
- Elevance Health (Waukesha, WI)
- ** LTSS Provider Network Manager , Contracting** **Location:** WI-Waukesha, N17W24222 Riverwood Dr., Ste 300 Please note that per our policy on ... virtual work, promoting a dynamic and adaptable workplace. The ** LTSS Provider Network Manager...or any combination of education and experience, which would provide an equivalent background. Travels to worksite and other… more
- CVS Health (Harrisburg, PA)
- …group/system providers. Conduct extensive cold calling to recruit providers and build provider network + Manage the full contracting process, including pre- ... managing the end-to-end contracting process to ensure timely participation in our network . The position requires a high volume of cold calls, persistent follow-up,… more
- Elevance Health (Waukesha, WI)
- ** Manager Provider Network Management- LTSS (Wisconsin Family Care)** **Location:** WI-Waukesha, N17W24222 Riverwood Dr., Ste 300 Please note that per our ... with the autonomy of virtual work, promoting a dynamic and adaptable workplace. The ** Manager Provider Network Management- LTSS (Wisconsin Family Care)**… more
- Molina Healthcare (Warren, MI)
- …Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting (Long Term Support Services, LTSS ) jobs are responsible for ... negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of... providers to reduce member access grievances. * Supports network LTSS development throughout state to including… more
- Elevance Health (Neillsville, WI)
- …an accommodation is granted as required by law. The ** LTSS ** ** Network Relations Consultant** develops and maintains positive provider relationships with ... ** LTSS ** ** Network Relations Consultant** **Location: We...May participate in Joint Operation Committees (JOC) of larger LTSS provider groups. Coordinates communication process on… more
- Commonwealth Care Alliance (Boston, MA)
- …preferred. * 1+ years of experience in LTSS , social work, provider relations, healthcare communications, project management, or network management within a ... have direct reports. Essential Duties & Responsibilities: * Support LTSS network program operations o Developing agendas,...support o Link with CCA's Business Intelligence team and Provider Engagement Analytics Manager to request reports… more
- Molina Healthcare (Boston, MA)
- …based on the severity of illness and the site of service. The Care Manager , LTSS provides support for care management/care coordination long-term services and ... member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. This position will support our… more
- Molina Healthcare (West Union, IA)
- JOB DESCRIPTION Opportunity for an experienced Care Manager who is Bachelors or Masters trained in a social services field to join the LTSS team with our Iowa ... to determine the types of services we need to provide and managing their care until they are discharged...The ideal candidate will have experience as a Care Manager within a managed care organization (MCO) like Molina… more
- Elevance Health (Chillicothe, OH)
- ** LTSS Service Coordinator (Case Manager )** **Hiring near Cambridge, Colerain, Chillicothe, Coschocton, Hillsboro, Ironton, Mansfield, Marion, Mount Orab, Mount ... behavioral health, long term services and supports, and psychosocial needs. The ** LTSS Service Coordinator** is responsible for managing service coordination for a… more
- Molina Healthcare (Kenosha, WI)
- …member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes ... caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. * Performs ongoing… more
- Molina Healthcare (Detroit, MI)
- …member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes ... caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. * Performs ongoing… more
- Molina Healthcare (Dallas, TX)
- …completing assessments needed for determining the types of services we need to provide . Preference will be given to those candidates with previous experience working ... with the LTSS population receiving waiver services. Mileage is reimbursed as...physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. +… more
- Molina Healthcare (Brockton, MA)
- …caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. + Conducts face-to-face ... member to address concerns. + 25- 40% local travel required. + RNs provide consultation, recommendations and education as appropriate to non-RN case managers. + RNs… more
- Molina Healthcare (Boise, ID)
- …member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. + Performs ongoing ... or social work OR any combination of education and experience that would provide an equivalent background **REQUIRED EXPERIENCE:** + At least 1 year of experience… more
