- ChenMed (Philadelphia, PA)
- …Knowledge of products, services, standards, policies and procedure s in a healthcare environment + Network Management experience/understanding + ... medical personnel in a dynamic and professional environment to provide the highest level of quality healthcare ...List is used accurately and effectively. Collaborates with referral management to ensure specialist network is adequate… more
- Highmark Health (Pittsburgh, PA)
- …and payment strategy. The role also leads the strategy and creation of provider network designs and programs. The incumbent is responsible for understanding ... to drive provider performance in the domains of reimbursement and network programs. Specifically, the incumbent will lead the strategy and creation of… more
- The Cigna Group (Erie, PA)
- **WORK LOCATION: Pittsburgh, PA - Western PA/West Virginia market** The **Manager, Provider Contracting Network Management ** serves as an integral member of ... management of the day to day contracting and network management activities for a local given...provider contracts and alternate contract terms. + Creates healthcare provider agreements that meet internal operational… more
- CenterWell (Harrisburg, PA)
- …fast-paced, matrixed environment. + Knowledge of healthcare reimbursement models, provider network management , and value-based care principles. ... and strategic insights to drive value-based specialty care programs, specialty provider network development, and financial performance. The Senior Analyst… more
- Magellan Health Services (PA)
- …years' experience in a Healthcare environment 2+ years' experience in network development Excellent organizational and time management skills. Ability to ... experience. + Act as liaison between Clinical, Quality, and Network and the provider community, sharing ... adequacy, network trends, and recruitment to Network Management and internal Magellan teams. (10%)… more
- Highmark Health (Harrisburg, PA)
- …with contractual terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and ... (providers, dental industry, organized dentistry and dental consultants) keeping management informed on related healthcare industry issues/topics. Support… more
- Highmark Health (Pittsburgh, PA)
- …Professional Provider fraud, waste and abuse (FWA) settlements and/or healthcare audit consulting experience with strong project management and relationship ... by audits, vendor audits and analysis activities, (c) actively communicating with management from various departments regarding impact on provider relations and… more
- Evolent (Harrisburg, PA)
- …Account teams and payer clients to align priorities and deliver high-quality provider network engagement, performance reporting, and present to health plans ... advisory panels + Own market level engagement strategy and collaborate with provider engagement market managers to ensure change management initiatives are… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Director, Network Strategy is tasked with developing and implementing provider network strategies based on advanced market research, intelligence and ... management , pricing and actuary, provider performance programs, and local provider network resources to lead and deploy programmatic solutions, as well… more
- St. Luke's University Health Network (Allentown, PA)
- …and that contractual obligations are aligned to business goals + Communicate vendor management benefits and create synergy across the Network + Point of ... + Develop and maintain strong strategies & methodologies, and provide leadership and direction to the VCMO ensuring full...areas. + Proactively reports out to each level of management within the Network , as required, to… more