- 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 ... accountable for any program or strategic tactic to drive provider performance in the domains of reimbursement and ...provider performance in the domains of reimbursement and network programs. Specifically, the incumbent will lead the strategy… more
- Guardian Life (Bethlehem, PA)
- As a Dental Network Provider Relations team member, you will work directly with contracted providers to help resolve issues, assess and negotiate provider ... with providers + Research and resolve a variety of provider issues + Grow knowledge base of Network...forth all reasonable efforts to retain providers in the network + Provide outstanding customer service to… more
- AmeriHealth Caritas (Harrisburg, PA)
- **Role Overview:** The Provider Network Contract Representative oversees the daily operations related to Out of Network (OON) agreements, provider ... applications. This role ensures the timely and accurate processing of provider agreements and supplemental packets, maintains detailed records, and supports… more
- The Cigna Group (Philadelphia, PA)
- …a highly motivated and innovative team member to join our growing and dynamic Network Analytics team as a Business Analytics Associate. In this role, you will ... support the medical cost position of assigned markets through analysis of healthcare provider contracts, data drill downs of contract trend drivers, and execution of… more
- St. Luke's University Health Network (Easton, PA)
- …our PCA's to provide top quality care to our patients. The Network Float (Central Staffing) PCA is an experienced professional motivated by the challenge of ... every situation. The St. Luke's Central Staffing Department provides support to the Network Campuses as necessary to ensure appropriate staffing levels which allow… more
- St. Luke's University Health Network (Easton, PA)
- …situation. The St. Luke's Central Staffing Department provides support to the Network Campuses as necessary to ensure appropriate staffing levels which allow our ... nurses to provide top quality care to our patients. The Central...providing care to patients in nursing settings across the network . This professional must posses a multi-disciplinary skill set… 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 the ... Provider Contracting Team and reports to the AVP, ...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- Magellan Health Services (PA)
- …supportive provider experience. + Act as liaison between Clinical, Quality, and Network and the provider community, sharing provider feedback to internal ... position is responsible for building, maintaining and enhancing relationships with network providers by sharing performance, quality, and other value-based data.… more
- AmeriHealth Caritas (Newtown Square, PA)
- …makes available to the local markets. A deep understanding of network contracting strategies, credentialing, value-based compensation, provider data management ... essential, as well as a expertise related to how network operations and provider data integrity impacts...outcomes and reduce redundancy between the local and corporate Network teams. ; **Organizational Leadership:** + Provide … more
- Highmark Health (Harrisburg, PA)
- …marketplace by staying abreast of changes to the business climate. Monitor provider reimbursement methods and PPO/DHMO/EPO network models and communicate changes ... territory in a remote and mobile work environment. Manage network contracts including negotiations, contract development/renewal and financial reimbursement. Meet… more