- Centene Corporation (Harrisburg, PA)
- …Purpose:** Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery ... of care to our members. Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for… more
- Guthrie (Sayre, PA)
- …Degree in related field is preferred. Essential Functions Leadership and Mentorship: Provide guidance and mentorship to Provider Onboarding Coordinators. Act as ... Summary The Senior Provider Onboarding Specialist oversees the onboarding process for...Conduct regular audits to ensure compliance with regulatory standards. Provide detailed reports to leadership. Collaborates with credentialing, enrollment,… more
- Humana (Harrisburg, PA)
- … Network Payment Solutions (INPS) department which falls under the Provider Process and Network Organization (PPNO). The Senior Business Intelligence ... and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior...age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our… more
- CVS Health (Harrisburg, PA)
- …support audit readiness and collaborates with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure alignment with ... Lead Director will also serve as a key liaison between Compliance, Legal, Network Contracting, and Provider Relations teams. **Required Qualifications** + A… more
- Highmark Health (Pittsburgh, PA)
- …key liaison to external professionals serving on the MRC; prepares and presents provider / network appeal cases; and/or providing technical expertise in ... for the execution of the strategic plan of the Financial Investigations & Provider Review (FIPR) organization. The strategic plan focuses on the detection and… 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 ... SOUTHWEST REGION We are seeking a strategic and collaborative Associate Director, Provider Engagement to lead our oncology-focused provider engagement and… more
- CVS Health (Harrisburg, PA)
- … Network Operations function. + The role is responsible for supporting Aetna's provider network by facilitating new provider applications, managing ... follow these workflow expectations towards production expectations + Respond to provider inquiries ( Network Assistance Form tickets) spanning several types… more
- Guardian Life (Bethlehem, PA)
- …is seeking a resolute motivated individual to join our team as a Dental Network Pricing Consultant. This role will be responsible for leading a team of analysts ... evaluating and optimizing PPO and DHMO provider compensation as well as providing thought leadership in...as well as providing thought leadership in the Dental network development strategy. This role involves developing and implementing… more
- CVS Health (Harrisburg, PA)
- …Promote collaboration with internal partners. * Evaluate, formulate, and implement the provider network strategic plan to achieve contracting targets and manage ... your next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager. In this role, you will manage negotiations, conduct high-level… more
- Highmark Health (Erie, PA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** The Advanced Practice Providers at Allegheny Health Network are an integral ... part of the care delivery system working together to provide a healing environment, by placing our customers first....organization. **Empower Your Passion for Patient Care: Advanced Practice Provider at AHN Express Care Erie.** **Are you a… more