- CVS Health (Providence, RI)
- …internal partners. + Evaluates, helps formulate, and implements the provider network strategic plans to achieve contracting targets and manage medical costs ... + Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements...through effective provider contracting to meet state contract and product requirements. +… more
- CenterWell (Providence, RI)
- …performs analysis regarding pharmacy claims and network composition to identify contracting needs to provide adequate coverage for Humana Health Horizons ... caring community and help us put health first** The Senior Pharmacy Contracting Professional is responsible for...put patients at the center. As the nation's largest provider of senior -focused primary care, one of… more
- CVS Health (Providence, RI)
- …we do it all with heart, each and every day. **Position Summary** Supports network teams in provider negotiations and financial risk for Commercial, Medicare, ... directly with network , provides current and relevant data to support provider negotiations. + Communicate network performance analysis to Market leaders,… more
- CVS Health (Providence, RI)
- …guidelines in support of global and regional network strategies. Expand International provider network by contracting new direct pay providers and manage ... , medical cost management and overall claim/customer service strategies. Provide concierge level of service to our members via...regarding your assigned TPA(s). + Manage day to day provider operations, either direct or through network … more
- Prime Therapeutics (Providence, RI)
- …risk 20% + Develops and maintains a strong positive working relationship with Senior leadership in many areas, including Sales, Network Management, Trade ... It fuels our passion and drives every decision we make. **Job Posting Title** Senior Principal, Health Plans Underwriter - REMOTE **Job Description** The Senior … more
- Humana (Providence, RI)
- …network build and coordinate with health plan operational functions. This includes network contracting , provider operations, value-based payment, and ... implementation activities. The Senior Project Manager (Medicaid Network Implementation) translates network and provider...Bachelor's Degree or 5+ years of Medicaid managed care, network contracting , network / provider … more
- Cardinal Health (Providence, RI)
- …At-Home Solutions ("AHS") business clients, a leading home healthcare medical supplies provider serving people with chronic and serious health conditions in the ... a direct-to-home medical supplies distributor, and (4) Velocare, a supply chain network and last-mile fulfillment solution capable of quickly reaching patients with… more
- Cardinal Health (Providence, RI)
- …VP, Revenue and Payor Operations **Location** Nationwide, US **Position Summary** Senior executive leader responsible for leading all aspects of Navista's Physician ... members, and innovation + Develops and implements managed care contracting strategy including implementation of value-based reimbursement initiatives. Responsible… more
- CenterWell (Providence, RI)
- …CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of ... Kentucky, Tennessee, Louisiana, and more. The PCO has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and is… more
- Humana (Providence, RI)
- …skills. + Experience working collaboratively across multiple functional areas (eg operations, provider network , contracting ) while fostering teamwork. + ... company committed to improving the health of the communities it serves. The Senior Insurance Product Content Professional will oversee and manage projects for member… more
- Prime Therapeutics (Providence, RI)
- …that have financial implications + Prepares materials and reports, and presents to Senior Leadership and Executive Leadership teams + Acts as a primary source of ... financial truth in legal contracting of new and existing clients, ensuring detailed contract...working relationship with leadership in many areas, including Sales, Network Management, Trade Relations, and Client Engagement, as well… more