- The Cigna Group (Los Angeles, CA)
- …Glendale, CA market. Must live in the Glendale/Los Angeles, CA area.** The **Manager, Provider Contracting Network Management ** serves as an integral member ... management of the day to day contracting and network management activities for a local given...and manages initiatives that improve total medical cost and quality . + Drives change with external provider … more
- LA Care Health Plan (Los Angeles, CA)
- …departments (Member Services, Provider Network Operations, Claims, Utilization Management , Pharmacy, and Quality Management ) to ensure the use ... the right time. Mission: LA Care's mission is to provide access to quality health care for...work collaboratively with multiple departments (Claims, Provider Network Operations, Utilization Management , Quality … more
- LA Care Health Plan (Los Angeles, CA)
- …position is responsible to conduct ongoing data quality auditing of LA Care's provider network data, including working with their assigned provider ... Add Change Delete Workflow (PCDW) tasks by continuous provider network data quality oversight... Provider Network interaction experience. Preferred: Provider Relations, management or sales experience. Policy… more
- Sharp HealthCare (San Diego, CA)
- …external research to identify potential providers for the Sharp Health Plan provider network .Works closely with utilization management and contracting ... market expertise, including market issues, provider reputations, provider strengths and weaknesses, provider quality...improve internal and external processes for provider management .Monitors and analyzes provider network … more
- CVS Health (Sacramento, CA)
- …in 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 ... Promote collaboration with internal partners. * Evaluate, formulate, and implement the provider network strategic plan to achieve contracting targets and manage… more
- Molina Healthcare (Riverside, CA)
- …and must live in California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... to business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** Manages the Plan's … more
- Molina Healthcare (Long Beach, CA)
- …and contracted provider network . They are responsible for network management including provider education, communication, satisfaction, issue intake, ... service area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract, network development and management , or… more
- Centene Corporation (Sacramento, CA)
- …or equivalent experience. Three or more years of provider engagement account management and /or provider quality improvement experience. Project ... , and cost utilization. Participate in the development of network management strategies. Assists in the strategic...plan ensuring a coordinated effort in improving financial and quality performance + Triages provider issues as… more
- Molina Healthcare (Long Beach, CA)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... Medical Care Ratio (MCR) within each region. * Advises Network Provider Contract Specialists on negotiation of...models. Seeks input on new reimbursement models from Corporate Network Management , legal and VP level engagement… more
- WelbeHealth (Fresno, CA)
- …of one (1) year of experience in provider network development and/or provider network management capacity, account management , or provider ... Partnership team leads the charge by building meaningful relationships with our provider network partners, while ensuring excellent clinical care to those we… more