- Bon Secours Mercy Health (Cincinnati, OH)
- …care sites and clinicians are recognized for clinical and operational excellence. **DIRECTOR MANAGED CARE CONTRACTING - LARGE ACCOUNTS** **| REMOTE** This ... responsible for developing, managing, and leading the day-to-day activities associated with managed care contracting for both fee for service and risk… more
- Cardinal Health (Columbus, OH)
- …that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting , enrollment, credentialing, and any other ... (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing legal review,… more
- Highmark Health (Columbus, OH)
- …Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population ... drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark Health… more
- The Cigna Group (Cleveland, OH)
- …+ Intimate understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models. + Team player with ... position serves as an integral member of the Provider Contracting Team and reports to the Vice President, Network...of life. We guide our customers through the health care system, empowering them with the information and insight… more
- The Cigna Group (Independence, OH)
- …relationships with provider partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team player with ... reside in the Cleveland or Independence, OH area.** The **Director** **,** **Provider Contracting Network Management** serves as an integral member of the Provider … more
- Trinity Health (Columbus, OH)
- …supports performance in alternative payment models. Collaborates with MCHS and Trintiy Health managed care teams on APM contracting . Attends Board meetings ... design, development and implementation of agreed upon clinical strategies. Partners with Managed Care leadership in the development of managed care … more
- Medical Mutual of Ohio (OH)
- …**Technical Skills and Knowledge** . Comprehensive knowledge of provider network development, contracting , managed care , and regulations and the ability ... (MHA) preferred. . 8 years progressive experience in provider network development, managed care , or equivalent, 5 years of which are in a managerial capacity.… more
- CVS Health (Columbus, OH)
- …Medicaid knowledge * 5+ years related experience, proven and proficient managed care network negotiating skills. * 3+ years contracting for large facilities ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Prime Therapeutics (Columbus, OH)
- …healthcare or other highly regulated industry; including 5 years of managed care experience in medical or pharmacy network contracting + Must be eligible ... implement network initiatives by facilitating and performing network analyses, contracting activities and fee schedule development aligning with strategy, priorities… more
- Elevance Health (Mason, OH)
- …or related field; minimum of 5 years of experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical ... Consultant** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the… more