- Seattle Children's (Seattle, WA)
- We are seeking a dedicated **Advanced Practice Provider (Nurse Practitioner or Physician Assistant)** to join our Child Protection Team. This part-time position ... independent and team-based clinical practice and consultation in the evaluation and management of pediatric patients referred for possible child abuse and neglect.… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and ... and accurate accounting of time allocated to each audited provider . + Analyzing data in Excel or...as strong written/verbal communications skills preferred. Strong computing and data management abilities, analytical, and interpersonal and… more
- Centene Corporation (Lincoln, NE)
- …including a fresh perspective on workplace flexibility. As a key member of the ** Provider Network Performance** team, you will be at the forefront of enterprise ... advanced financial analysis to distil key business insights and support data -informed decision making. Manage multiple initiatives from inception to completion,… more
- LA Care Health Plan (Los Angeles, CA)
- …operations (including but not limited to, claims processing; provider contracting, network and data management ; complex pricing mechanisms; etc.) and ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....work product. This position collaborates closely with peers and management within the department as well as throughout and… more
- Commonwealth Care Alliance (Boston, MA)
- …quality, compliance, medical management , and analytics teams to advance provider network operations, education, and performance improvement. The Provider ... Experience (must have): * 8-10 years of progressively responsible experience in provider relations, network management , or healthcare operations within… more
- UPMC (Freeport, PA)
- …with peers, engineers, and business partners. * Familiarity with the operational support of data networks and network management tools through education or ... servers, etc.) as part of projects and initiatives. * Provide Level 1 support across UPMC's network infrastructure. * Maintain data center and facility… more
- CVS Health (Columbus, OH)
- …will be accountable for the strategic alignment, operational success and performance management of assigned provider relationships, network and value-based ... successfully and working to improve quality of care while reducing costs. . Provider Relationship Management - Understands the terms of the value based… more
- Commonwealth Care Alliance (Boston, MA)
- …or One Care) populations preferred. * Experience in healthcare program management , provider relations, or network management * Knowledge of Massachusetts ... CCA's behavioral health priorities, programs, and initiatives to the provider network . * Promote provider ...and Data Insight * Analyze and interpret provider data related to utilization, cost, quality,… more
- Highmark Health (Charleston, WV)
- …health care/health insurance industry to include value-based care and provider relations/ network management + Experience with data analytics and trending ... care alignment reports, and other resources that will produce value for Highmark, the provider partner, and the member. + Utilize data to make informed… more
- Magellan Health Services (Boise, ID)
- … network adequacy, network trends, and recruitment to Network Management and internal Magellan teams. + Provide summary and problem specific feedback ... engagement plan. Responsibilities include building and maintaining an adequate provider network to meet the needs of...information, analysis and action recommendations to management and relevant functional units regarding provider … more