- 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 (Philadelphia, PA)
- …you will support the medical cost position of assigned markets through analysis of healthcare provider contracts, data drill downs of contract trend drivers, and ... to address unit cost and competitive discount. You will partner with contracting, network management , and pricing business units to deliver contract analysis… 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
- AmeriHealth Caritas (Newtown Square, PA)
- …the local network teams and move to a broader " network management " mindset versus a traditional focus on provider service. + Drive a standardized ... deep understanding of network contracting strategies, credentialing, value-based compensation, provider data management and network operations is… 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 (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
- Prime Therapeutics (Harrisburg, PA)
- …+ 8 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 5 years of ... that. It fuels our passion and drives every decision we make. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network … 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