- Commonwealth Care Alliance (Boston, MA)
- …position partners closely with provider engagement, delegation partnerships, provider services, contracting , quality, compliance, medical management, and ... (DSNP) populations preferred. * 10+ years of experience in provider relations, contracting , or network operations, including 3-5 years in a director… more
- AmeriHealth Caritas (Washington, DC)
- …compliance with pricing guidelines established by AMC and Plan. + Ensures provider contracting is consistent with claim payment methodologies. + Maintains ... health insurance, ACA Exchange Business & DSNPs. + 5 years provider contracting /reimbursement experience in healthcare setting. + 3 years of supervisory/… more
- Highmark Health (Pittsburgh, PA)
- …information to derive conclusions to support contract negotiations. Conducts periodic review of provider contracting rates to ensure strategic focus is on target ... coordination with various departments as well as leading the negotiation for the contracting team. Establishes a provider recruitment plans for expansion, new… more
- Health Care Service Corporation (Philadelphia, PA)
- …responsible for the management, mentoring and training of a team responsible for provider contracting and provider support resources, providing subject ... in a value-based market **Job Requirements:** + Bachelor Degree and 5 years provider contracting experience OR 9 years managed care experience including 5 years … more
- Molina Healthcare (West Valley City, UT)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to ... different provider contract types, ie physician, group and hospital contracting , etc. * Working familiarity with various managed healthcare provider … more
- Point32Health (RI)
- …and analysis of new reimbursement strategies and financial analytics supporting provider contracting in the Point32Health network. + Summarize findings ... Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for...of regulatory requests. + Coordinates and oversees the annual re- contracting of the provider network for commercial… more
- Elevance Health (Richmond, VA)
- …provides the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you will make an impact:** + Focuses ... scale initiatives with high dollar cost savings opportunities. + Partners with provider contractors to develop contracting strategy and supports all aspects… more
- Elevance Health (Indianapolis, IN)
- …**Requirements:** BA/BS degree and a minimum of 5 years' experience in contracting , provider relations, provider servicing; experience should include ... an accommodation is granted as required by law. The ** Provider Network Manager Sr.** develops the provider ...development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the… more
- AmeriHealth Caritas (Southfield, MI)
- …and AmeriHealth Caritas's executive leadership. **Responsibilities:** + Leads comprehensive provider contracting strategy to achieve cost-efficient and ... + 10 or more years of experience years of managed care provider contracting and reimbursement experience, including in-depth knowledge of reimbursement… more
- Molina Healthcare (TX)
- …advocate and engage as valuable partners. + Requires an in-depth knowledge of provider services and contracting subject matter expertise. + Resolves complex ... different provider contract types, ie, physician, group and hospital contracting , etc. + Working familiarity with various managed healthcare provider … more
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