- The Cigna Group (Fort Lauderdale, FL)
- …need to work in the office or visit Providers 3 days per week The **Manager, Provider Contracting Network Management ** serves as an integral member of the ... 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
- Molina Healthcare (FL)
- …to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. ... + Generates and prepares provider -related data and reports in support of Network Management and Operations areas of responsibility (eg, Provider … more
- CVS Health (Tallahassee, FL)
- …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 (FL)
- …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
- Molina Healthcare (St. Petersburg, FL)
- **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
- Highmark Health (Tallahassee, FL)
- …with contractual terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and ... marketplace by staying abreast of changes to the business climate. Monitor provider reimbursement methods and PPO/DHMO/EPO network models and communicate changes… more
- The Cigna Group (Sunrise, FL)
- …Cigna's competitive position. + Supports initiatives that improve total medical cost and quality . + Drives change with external provider partners by offering ... office or visit Providers 3 days per week The ** Provider Contracting Lead Analyst** serves as an integral member...assists and supports the day to day contracting and network activities. **DUTIES AND RESPONSIBILITIES** + Manages submission process… more
- Centene Corporation (Orlando, FL)
- …Manages Network performance for assigned territory through a consultative/account management approach + Evaluates provider performance and develops strategic ... of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management , or clinical operations.… more
- Centene Corporation (New Port Richey, FL)
- …of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management , or clinical operations. ... network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in… more
- Evolent (Tallahassee, FL)
- …Strategic Account teams and payer clients to align priorities and deliver high- quality provider network engagement, performance reporting, and present ... performance within your territory. You will design and execute strategies that elevate provider performance, enhance care quality , and drive improved outcomes in… more