- Centene Corporation (New York, NY)
- … Engagement Operating Model (PEOM), an enterprise strategic priority focused on driving provider cost and quality performance and engagement. + Manage the staff ... policies and procedures, managing provider relationships to maintain/improve provider satisfaction, provide assistance in escalating claim issues,… more
- Molina Healthcare (Bellevue, NE)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (MA)
- …in HEDIS and quality initiatives. * Engages contracted network providers regarding cost control initiatives, Medical Care Ratio (MCR), non-emergent utilization, ... * 5-7 years managed healthcare administration experience. * Specific experience in provider services, operations, and/or contract negotiations in a Medicare and… more
- Molina Healthcare (Dallas, TX)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- Molina Healthcare (Miami, FL)
- …supports assigned contracts with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes reports according to ... Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider 's office,… more
- Prime Therapeutics (Santa Fe, NM)
- …Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose ... purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven...the future of pharmacy with us. **Job Posting Title** Provider Relations Manager - Remote **Job Description** The Manager… more
- The Cigna Group (Pittsburgh, PA)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team… more
- Parsons Corporation (Centreville, VA)
- …narrative. + Advise internal clients on risk mitigation and development of winning cost narratives + Lead narrative reviews and provide guidance to proposal ... professional product are completed in a timely manner + Provide support for subcontract solicitations and contract ...or any other protected status. We truly invest and care about our employee's wellbeing and provide … more
- CVS Health (Denver, CO)
- …to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. + Negotiates settlements as needed. ... build collaborative relationships with providers and work cross-functionally to resolve complex provider contract issues. + Highly organized and able to… more
- Parsons Corporation (Sacramento, CA)
- …to join our dynamic team. This role requires expertise in project controls, cost forecasting, contract management, and invoice review. The ideal candidate will ... in **Rocklin, CA** or **Paradise, CA** . **Key Responsibilities** ** Cost Management and Forecasting:** + Perform cost ...or any other protected status. We truly invest and care about our employee's wellbeing and provide … more