- Point32Health (RI)
- …of regulatory requests. + Coordinates and oversees the annual re-contracting of the provider network for commercial business. + Works with other departments, ... that focus on medical cost, utilization, membership, trends, and comparisons of provider reimbursement positions (using MRF and other data sources).Based on… more
- RTX Corporation (Beale AFB, CA)
- …can be focused, or a combination of systems administration, software management , network management , or data analytics. Desired military experience and ... AFB, CA, operating on a rotating shift schedule. Collins Aerospace is a provider of SkillBridge Fellowship opportunities for transitioning service members to gain an… more
- AmeriHealth Caritas (Manchester, NH)
- … reimbursement setups + Ensure that provider payment issues submitted by Provider Network Management or any other source are validated, researched, ... Senior Provider Network Operations Analyst is responsible for maintaining current provider data and setting up provider reimbursement, as well as… more
- CVS Health (Scottsdale, AZ)
- …we do it all with heart, each and every day. **Position Summary** As a Provider Enrollment Analyst, your primary responsibility will be acting as a point of contact ... by providing their members access to the CVS Health network of pharmacies. **Required Qualifications** - 2+ years minimum...Microsoft Excel, Outlook, Word, Power Point, and Adobe - Data entry and Contract operations skills - Ability to… more
- AmeriHealth Caritas (Charleston, SC)
- … reimbursement set up. + Ensure that provider payment issues submitted by Provider Network Management or any other source are validated, researched and ... The primary purpose of the job is to be responsible for the maintaining current provider data and provider reimbursement set up, and to address … more
- AmeriHealth Caritas (Charleston, SC)
- …of the job is to be responsible for the oversight of the local Plan's Provider data , reimbursement rules, and address provider inquiries and complaints. In ... up + Ensure there is a sufficient tracking of Provider data issues, progress and status for...as a member of a team as well as provide day-to-day leadership to support staff + Perform other… more
- AmeriHealth Caritas (Miami, FL)
- …+ Medicare, Medicaid, Commercial, or ACA Exchange experience preferred. + Experience in provider data management , including maintaining accurate provider ... re-credentialing, member complaints, and quality of care investigations. + Maintain accurate provider data in Facets and coordinate updates with the … more
- Highmark Health (Pittsburgh, PA)
- …and payment strategy. The role also leads the strategy and creation of provider network designs and programs. The incumbent is responsible for understanding ... to drive provider performance in the domains of reimbursement and network programs. Specifically, the incumbent will lead the strategy and creation of… more
- Omaha Children's Hospital (Omaha, NE)
- …care transitions. + Facilitate and supporting regular meetings with leadership board. Provide data -driven network administrative leadership, directing the ... disabilities. **A Brief Overview** The Program Manager for Community Provider Network Relations is responsible for the...a regional network of community providers (the " Network "). The Program Manager (PM) will provide … more
- AmeriHealth Caritas (Raleigh, NC)
- …working to resolve provider issues. ;Responsible for monitoring and managing provider network by assuring appropriate access to services throughout the ... positive working relationships between Plan and its contracted providers. ;Assigned provider accounts may include single or multiple practices in single or… more