- Elevance Health (Des Moines, IA)
- ** Provider Contract Cost of Care Consult Senior / 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 Consult...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Humana (Des Moines, IA)
- …the health of the communities we serve. The Regional Vice President will also provide executive leadership to Provider Contracting, Provider Education and ... Develop and lead efforts re: continuous improvement for unit cost strategy. + Ensure access to care ...with internal partners to ensure best in class credentialing, contract load and directory accuracy + Incorporate provider… more
- Molina Healthcare (Des Moines, IA)
- …supports assigned contracts with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes reports according to ... Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider 's office,… more
- Molina Healthcare (Des Moines, IA)
- …standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost -effective member care . Essential ... related business documents. Required Qualifications * At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more… more
- Molina Healthcare (Des Moines, IA)
- …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 (Des Moines, IA)
- …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 (Des Moines, IA)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... health care concerns, uses clinical judgment to provide care management or refer members to...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
- Molina Healthcare (Des Moines, IA)
- …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 (Des Moines, IA)
- …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... Must reside in Iowa** JOB DESCRIPTION Job Summary Provides support for care management/ care coordination activities and collaborates with multidisciplinary team… more
- CVS Health (Urbandale, IA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... heart, each and every day. **Position Summary** As a pharmacist for our Long-Term Care Pharmacy, you will work in an exciting, dynamic and fast paced environment,… more
- Molina Healthcare (Des Moines, IA)
- …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 (Des Moines, IA)
- …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 (Des Moines, IA)
- …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
- Iowa Department of Administrative Services (Des Moines, IA)
- …Child Care Assistance, and Rent Reimbursement. The Economic Assistance Contract Manager provides the requisite program oversight and coordination for all aspects ... Contract Managers will participate in initial request for proposal processes, contract development, and provide direct contract oversight for compliance… more
- Humana (Des Moines, IA)
- …. The case manager will offer guidance, support, and coordination of the beneficiary's care as directed by the beneficiary, the provider (s) or other members of ... needs of TRICARE beneficiaries, to maximize each beneficiary's capacity for self- care , to cost -effectively achieve desired clinical outcomes and to enhance… more
- CVS Health (Des Moines, IA)
- …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
- Humana (Des Moines, IA)
- …Professional contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct ... integrity, or healthcare data analytics, preferably within a managed care or payer environment. + Advanced proficiency in data...following systems: CAS, CISpro and CIS + Experience with provider contract payment analysis and knowledge of… more
- UMB Bank (Des Moines, IA)
- …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
- Ford Motor Company (Des Moines, IA)
- …Relationship Management: Provide feedback to valued supply partners on their cost position relative to the market to help build effective long-term, productive ... of great Ford and Lincoln vehicles. By partnering with dealerships, we provide financing, personalized service and professional expertise to thousands of dealers and… more
- Evolent (Des Moines, IA)
- …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