- The Cigna Group (Austin, TX)
- …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
- CVS Health (Austin, TX)
- …medical cost initiatives. Required Qualifications: + 3+ years of provider contracting and relationship experience, including contract language, rate ... key providers, ensuring timely resolution of escalated issues such as claims, contract interpretation, and provider data accuracy. + Negotiate settlements and… more
- The Cigna Group (Austin, TX)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team… more
- Centene Corporation (Lubbock, TX)
- …account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. + Serve ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- CVS Health (Austin, TX)
- …contracting, provider issues/resolutions, related systems and information contained. * Provide guidance and share expertise to others on the team. * ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- The Cigna Group (Plano, TX)
- …with health care data analysis, medical cost trend analysis and health care provider contract analysis + Understanding of managed care business ... marketplace. **Responsibilities** + Provide analytical and strategic support of health care provider rate negotiations + Identify opportunities for medical … more
- Molina Healthcare (Fort Worth, TX)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Planate Management Group LLC (Texas City, TX)
- …facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering, ... US federal agencies, all over the world. We are seeking an experienced Contract Specialist II to join our team in providing professional acquisition support services… more
- Molina Healthcare (Fort Worth, TX)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- CVS Health (Austin, TX)
- …+ 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