• Director, Provider Relations

    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
    Commonwealth Care Alliance (10/18/25)
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  • Manager Provider Network Management (Health…

    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
    AmeriHealth Caritas (10/30/25)
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  • Director Commercial Provider Contract

    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
    Highmark Health (12/18/25)
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  • Network Management Manager - Provider

    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
    Health Care Service Corporation (12/02/25)
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  • Provider Contracts Manager - Complex…

    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
    Molina Healthcare (12/07/25)
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  • Senior Network & Provider Analytics

    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
    Point32Health (10/10/25)
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  • Provider Contract/Cost of Care Consultant…

    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 (11/19/25)
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  • Provider Network Manager Sr.

    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
    Elevance Health (12/03/25)
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  • Vice President Provider Network Management

    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
    AmeriHealth Caritas (11/11/25)
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  • Senior Representative, Dental Provider

    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
    Molina Healthcare (11/28/25)
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