- Elevance Health (Durham, NC)
- ** Provider Contract / Cost of Care Consultant** **Locations:** This role requires associates to be in-office **1-2** days per week, fostering collaboration ... NOTE: This position is not eligible for current or future VISA sponsorship._ The ** Provider Contract / Cost of Care Consultant** provides analytical… more
- The Cigna Group (Raleigh, NC)
- …member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Network Underwriting Advisor. In this role, you will conducts ... hospital and professional provider contract underwriting/analysis, partnering with Contracting to...contract underwriting/analysis, partnering with Contracting to deliver unit cost results in line with trend/ cost expectations… more
- UNC Health Care (Raleigh, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high quality, cost effective care to patients within ... the health and well-being of the unique communities we serve. Join our growing UNC Urgent Care provider team! This is an employed position with UNC Rex and is a… more
- UNC Health Care (Butner, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... problem-solving, decision-making, and evaluating clinical/system issues and models of care . Leads interdisciplinary teams to provide integrated delivery… more
- UNC Health Care (Chapel Hill, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high quality, cost effective care to patients within ... problem-solving, decision-making, and evaluating clinical/system issues and models of care . Leads interdisciplinary teams to provide integrated delivery… more
- CVS Health (Raleigh, NC)
- …+ Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/Claims Research Medicaid team. Extensive claims research ... framework to make financial decisions to resolve provider issues. Explain provider 's rights and responsibilities in accordance with contract . + Process claim… more
- Elevance Health (Winston Salem, NC)
- … care plans and ensuring compliance with the service delivery of the delegated care management partner(s) who are in contract with Healthy Blue. Partners may ... referral to community services. + Supports member access to appropriate quality and cost -effective care and modifies plan(s) as needed. + Reviews daily reports… more
- UNC Health Care (Goldsboro, NC)
- …matters relating to physician performance . h. Leads Medical Staff improvements in care transitions, care standards, cost reduction initiatives, resource ... among the various clinical components of Wayne UNC Health Care with a goal of providing high quality, efficient...for the provision of services; coordinates across departments to provide a maximum level of services to patients, family,… more
- Intermountain Health (Raleigh, NC)
- …in care . Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved ... and training techniques. Based on medical record metrics and contract obligations, conducts patient outreach and follow up in...the efforts of providers and practice teams on office-based care delivery interventions resulting in cost of… more
- Elevance Health (Lincolnton, NC)
- …applicable state law and contract . **How you will make an impact:** + Provide integrated whole-person Care Management under the CFSP Care Management ... **CFSP Managed Care Coordinator** **Sign-on Bonus: $2500** **We are currently...of members with chronic illnesses, co-morbidities, or disabilities for cost -effective and efficient service utilization. + Set short- and… more