- Insight Global (Fountain Valley, CA)
- …building Enrollment File and Capitation R&R workflows. Knowledge of managed care operations and payer provider contracting Familiarity HL7, X12, XML, and/or ... other interface or Electronic Data Interchange (EDI) standards Strong understanding of HIPAA transaction sets High-level project management experience Minimum 5 years of experience in EDI operations within a healthcare environment. more
- Commonwealth Care Alliance (Boston, MA)
- …experience in provider relations, network management, or healthcare operations within a managed care organization, health plan, or integrated delivery system. * ... leads the strategic vision and operational execution of provider relations for Commonwealth Care Alliance's SCO and One Care lines of business. This role… more
- CVS Health (Charleston, WV)
- …the following key attributes: + 10+ years of experience in managed care ; leading and managing teams. + Experience contracting with providers and hospital ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Molina Healthcare (San Antonio, TX)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated delivery… more
- Molina Healthcare (Seattle, WA)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... Washington _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with… more
- Ascendis Pharma (Princeton, NJ)
- …administration of rebate programs, including government rebates (eg, Medicaid, Medicare), managed care rebates, and commercial rebates. Ensure accurate ... formulary validation processes accurately and before payment deadlines, oversee payments of managed care and government rebates, and manage Market Access… more
- CVS Health (Springfield, IL)
- …and execution of Contracts with providers and delivery systems to participate in Aetna managed care networks. Work will include, but not be limited to active ... + Minimum 5 years related experience and comprehensive level of negotiating managed care contracts with individuals, complex provider systems, etc. +… more
- Elevance Health (Richmond, VA)
- …or related field and a minimum of 7 years of experience in broad-based analytical, managed care payor or provider environment as well as in depth experience in ... the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you will make an impact:** + Focuses efforts… more
- Molina Healthcare (Miami, FL)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy...large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider… more
- Martin's Point Health Care (Portland, ME)
- …health administration, health policy, finance or a related field required. + 5+ years of managed care or similar experience including managed care ... of building internal and external collaborative relationships. + Broad understanding of managed care business - medical expense trends, financial risk… more