• Provider Engagement Professional

    Humana (Springfield, IL)
    …LTSS) who are responsible for day-to-day, front-line relationship management for network providers in Humana. This role supports provider onboarding, training, ... and LTSS) roles and responsibilities include: + Serve as primary relationship manager with assigned providers to ensure positive provider experience with Humana's… more
    Humana (08/02/25)
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  • Medicare MAP Advisor

    Centers Plan for Healthy Living (Staten Island, NY)
    …new designs or benefit changes. + Works in a concerted manner with Provider Relations / Network Development and communicates to them any providers that we should ... performing all required tasks assigned by the Sales Field Manager . Incumbent will be responsible for educating and enrolling...attempt to recruit. + Ensures Provider Relations / Network Development Representatives are abreast on any… more
    Centers Plan for Healthy Living (10/14/25)
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  • Chief Psychiatrist - Behavioral Health Medical…

    Humana (Springfield, IL)
    …also lead the development of new products and services in Humana's Medicaid BH delivery model. **Position Responsibilities:** + Leads clinical and quality management ... and assists with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of prior authorization, clinical… more
    Humana (08/29/25)
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  • Credentialing Specialist I, Amazon Pharmacy

    Amazon (Seattle, WA)
    …centric pharmacy option. The Payer Biz Dev team is seeking a Risk Manager I to develop and execute foundational submission, reporting, risk analysis, and management ... be heavily involved in cross-functional activity and external PBM & State Medicaid communications. This individual will build and scale operational processes for… more
    Amazon (10/07/25)
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  • Supv Accts Rec FollowUp Denial / PA Third Party…

    Hartford HealthCare (Farmington, CT)
    …team leads and staff including management of human resources, vendors, and client relations . This position reports directly to the Manager of Patient Financial ... here. We invite you to become part of Connecticut's most comprehensive healthcare network . The creation of the HHC System Support Office recognizes the work of… more
    Hartford HealthCare (10/07/25)
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  • Licensed Benefits Advisor (Field Based)

    Centers Plan for Healthy Living (Queens, NY)
    …new designs or benefit changes. + Works in a concerted manner with Provider Relations / Network Development and communicates to them any providers that we should ... and performing all required tasks assigned by the Sales Manager . Incumbent will be responsible for educating and enrolling...attempt to recruit. + Ensures Provider Relations / Network Development Representatives are abreast on any… more
    Centers Plan for Healthy Living (10/14/25)
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  • Team Lead (AR III) Hybrid

    Methodist Health System (Dallas, TX)
    …correspondence. Knowledgeable with payors; Managed Care, Commercial, Medicare, and Medicaid Strong leadership skills with experience in team building, coaching, ... improvements to optimize billing workflows and increase efficiency. Collaborate with manager and leadership to streamline operations and enhance overall revenue… more
    Methodist Health System (10/02/25)
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  • AHD Infection Preventionist - PB

    Alameda Health System (Alameda, CA)
    …with requirements of The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Center for Disease Control (CDC), Occupational Safety and Health ... in all functions. + COLLECTS AND REPORTS DATA TO NATIONAL HEALTHCARE SAFETY NETWORK (NHSN): Maintains a current digital certificate and completed NHSN training for… more
    Alameda Health System (10/07/25)
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  • Utilization Management Nurse Supervisor

    Integra Partners (Troy, MI)
    …leadership duties, serving as both a mentor and performance manager for frontline staff. Salary: $75,000.00/Annually JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES ... overall team performance, escalating issues as needed to the UM Clinical Manager . + Ensure compliance with all regulatory, contractual, and accreditation standards… more
    Integra Partners (10/16/25)
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  • Provider Relationship Account Consultant

    Elevance Health (Wichita, KS)
    …Coordinates and conducts provider training including developing and distributing provider relations materials + May assist with Annual Provider Satisfaction Surveys, ... issues that may impact future provider contract negotiations or jeopardize network retention **Required Qualifications:** + Requires a bachelor's degree; a minimum… more
    Elevance Health (10/04/25)
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