- Molina Healthcare (Tampa, FL)
- …addressing the strategic goals of the department and organization. + Develops and implements Provider Network and Contract strategies across all lines of ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...within complex data sets and analytics ideally in the Healthcare or Payer field + 3-5 years' experience managing/supervising… more
- The Cigna Group (Fort Lauderdale, FL)
- …projects financial impact of larger or complex provider contracts and alternate contract terms. + Creates healthcare provider agreements that meet ... or visit Providers 3 days per week The **Manager, Provider Contracting Network Management** serves as an...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- Molina Healthcare (FL)
- … Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network . They are responsible for ... service area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or… more
- The Cigna Group (Sunrise, FL)
- …degree.** + **1+ years of Provider Contracting and Negotiating for Healthcare Provider /Ancillary group experience required** + **1+ years prior Provider ... cost initiatives. + Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms. + Creates "HCP" agreements… more
- Humana (Tallahassee, FL)
- …of diverse scope and complexity ranging from moderate to substantial. The Provider Contracting Executive communicates contract terms, payment structures, and ... more years of progressive network management experience including hospital contracting and network administration in a healthcare company + 2 or more years… more
- Molina Healthcare (Orlando, FL)
- …**Job Duties** * Reviews documentation regarding updates/changes to member enrollment, provider contract , provider demographic information, and/or claim ... requirements of customers as it pertains to contracting (benefit and provider ), network management, credentialing, prior authorizations, fee schedules, and… more
- Humana (Miami, FL)
- …a talented healthcare /health insurance leader for the role of Director, Provider Contracting. The Director will be responsible for all contracting and servicing ... execute value-based Medicare Advantage contracts and agreements with physicians and other healthcare providers + Manage the provider relationship, ensuring that… more
- Elevance Health (Tampa, FL)
- … an equivalent background. **Preferred Skills, Capabilities, and Experiences:** + Provider contract experience is preferred. + Claims experience preferred. ... that a claim is paid in accordance with the contract , provider reimbursement policies, and industry standards....based on historical results of other reviews with providers, network management input and dollar volume of provider… more
- Prime Therapeutics (Tallahassee, FL)
- …years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 5 years of managed care ... fuels our passion and drives every decision we make. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network Management… more
- CACI International (Cape Canaveral, FL)
- …networks in a fast-paced environment is essential. **Responsibilities:** + Troubleshoot complex network issues and provide timely resolutions + Provide ... Network Engineer Tier 3 Job Category: Information Technology...diagnosis, troubleshooting, and resolution of incidents and problems. + Provide support for the escalation and communication of status… more