- Centene Corporation (Baton Rouge, LA)
- …account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. + Serve ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- Centene Corporation (Tallahassee, FL)
- …management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. **Serve as ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care .** **Performance Management: Uses data… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …knowledge, and Premera product knowledge to foster a collaborative approach to quality care , network stability and cost containment. + Develop and maintain ... and internal leadership, providing industry and cross-market expertise. Create provider specific and public presentations. + Provide ...in payer or provider contracting and managing provider relationships in the health care or… more
- Molina Healthcare (St. Clair Shores, MI)
- …Duties** This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and ... of medical group/IPA and hospital contracting. * Identified as contract system lead by developing and maintaining provider...: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider… more
- Centene Corporation (Atlanta, GA)
- …account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. + Serve ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- The Cigna Group (Mclean, VA)
- …total medical cost and quality. + Drive change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... to the development of alternative network initiatives. Support and provide direction to develop network analytics required for the...and project the financial impact of larger or complex provider contracts and alternate contract terms. +… more
- The Cigna Group (Toledo, OH)
- …analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. + Manages key provider ... understanding and experience with larger, more complex integrated delivery systems, managed care , and provider business models. + Team player with proven… more
- The Cigna Group (Salem, OR)
- …quality reviews of Practitioner and/or Facility/Ancillary contracts. Conducts comparison of contract data relative to provider data and/or demographic and ... + Respond to provider inquiries, concerns, complaints, appeals and grievances + Provide ongoing product education to dentists and their staff + Work to achieve … more
- AmeriHealth Caritas (Southfield, MI)
- …financial performance by identifying cost -saving opportunities, ensuring competitive provider contracts, and enhancing value-based care . + Drives member ... Degree preferred. + 10 or more years of experience years of managed care provider contracting and reimbursement experience, including in-depth knowledge of… more
- CenterWell (Phoenix, AZ)
- …for quality management/ cost and utilization / develop interventions / evaluate provider workflows / + Attend team meetings / external Meetings / shared service ... Issues / Action Items in MSO Connect (membership, payment, contract load) + Email Inbox Management + Follow-up (existing...Bachelor's Degree + 5 or more years of Health care or managed care with Provider… more