- Humana (Columbia, SC)
- …of our caring community and help us put health first** The Director, Provider Contracting initiates, negotiates, and executes physician, hospital , and/or other ... Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms.… more
- Molina Healthcare (Gulfport, MS)
- …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
- WellSense (NH)
- …environment is preferred + Experience with Medicare and Medicaid Reimbursement Methodologies + Understanding of provider coding and billing practices ... insurance that works for our members, no matter their circumstances. **Job Summary:** The Provider Relations Consultant - NH will act as the primary liaison between … more
- Elevance Health (AR)
- …necessary. **Preferred Skills, Capabilities and Experiences:** + Medicare network contracting/ reimbursement methodology strongly preferred. + Medicaid and ... Provider Network Management Director (Medicare Network Build) JR167138...health systems and affiliated physician groups including employed and hospital -based and hospital owned ancillary providers. Primary… more
- AmeriHealth Caritas (Newark, DE)
- …**Roles and Responsibilities:** + Lead strategic planning, development, and management of the hospital and physician provider network to meet member needs and ... for our communities. They will develop and manage all hospital , physician, and extender networks. This position is also...minimum of 3 years of experience in managed care provider contracting and reimbursement is required, including… more
- Commonwealth Care Alliance (Boston, MA)
- …and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community - including physician, hospital , behavioral health, ... Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare/ Medicaid ) + Experience in health plan provider relations + Experience… more
- UCHealth (Longmont, CO)
- …course of practice. + Eligible to provide services, reimbursable services, and maintain provider status with Medicare and Medicaid . + Eligible to provide ... to world-class care. UCHealth Medical Group and the UCHealth Hospital Medicine team, located in Longmont, CO, are ready...to provide services, reimbursable services, and maintain provider status with Medicare and Medicaid . +… more
- Baylor Scott & White Health (Dallas, TX)
- …payer requirements, applications and workflows + Familiarity with PECOS and State Medicaid Provider Enrollment and Management Systems preferred + Experience ... **Job Summary** The Director, Provider Enrollment, is responsible for the strategic planning,...Ensures CMS attestations and applications are filed timely for hospital -based department designations + Oversees the build and maintenance… more
- Tidelands Health (Myrtle Beach, SC)
- …Tidelands and help people live better lives through better health!** **Supervisor Provider Coding Specialist** Are you passionate about quality and committed to ... Tidelands Health team. As our region's largest health care provider , we are also one of our area's largest...and accuracy of the coding team to ensure optimal reimbursement and goal attainment. The coding supervisor performs quality… more
- University of Southern California (Los Angeles, CA)
- …issues to the Manager as needed. + Monitor and interpret CMS, Medicare, and Medicaid reimbursement , including proposed and final IPPS and OPPS rules, CMS ... Business, Accounting or related field. + Req 3 years hospital reimbursement , with a strong focus on...Medicaid . + Req Experience with CMS and state Medicaid hospital payment systems and cost reporting… more