- Molina Healthcare (Fort Worth, TX)
- …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 (Austin, TX)
- …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 (Houston, TX)
- …outreach and resolving provider inquiries. * In conjunction with the Director, Provider Network Management & Operations, develops health plan-specific ... , corporate, and staff to develop and implement standardized provider servicing and relationship management plans. **Job...to increase provider engagement in HEDIS and quality initiatives. * Engages contracted network providers… more
- Molina Healthcare (TX)
- …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
- The Cigna Group (Houston, TX)
- …- **Candidate will be required to live in the Houston, TX area** 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 (Fort Worth, TX)
- … and senior leadership/ management . * Communicates new strategies to corporate provider network leadership for input. * Utilize standardized system(s) to ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...including VBP program templates. Works with Legal and Corporate Network Management as needed to modify contract… more
- Molina Healthcare (TX)
- **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 (Austin, TX)
- …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
- Centene Corporation (San Antonio, TX)
- …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
- Evolent (Austin, TX)
- …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