- PNC (Phoenix, AZ)
- …This position is primarily based in a location within PNC's footprint. Sr. Data Center Network Engineer with experience in design, implementation and 24x7 ... support of complex data center networks across... center networks across multiple locations. Knowledge of Cisco network equipment including Arista 7010TX,7060CX2, 7280CR2/3, 7280SR2/3 series of… more
- Molina Healthcare (Dallas, TX)
- …system lead by developing and maintaining provider contracts in contract management software. * Supports network development throughout state to including ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This… more
- The Cigna Group (Mclean, VA)
- …will assist in developing the strategic direction and managing day-to-day contracting and network management activities for a local territory. Your work will ... If so, read on to learn more! As a Provider Contracting Negotiator Manager at Cigna Healthcare, you'll be...risk arrangements. + Contribute to the development of alternative network initiatives. Support and provide direction to… more
- CareFirst (Baltimore, MD)
- …role will lead, guide, strategize and manage negotiations for provider -specific institutional, ancillary, and professional contracts. Key responsibilities include ... contract terms in accordance with regulatory requirements, analyzing financial data to evaluate implications across various business lines, while ensuring… more
- Molina Healthcare (Long Beach, CA)
- …and must live in California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... critical provider information on all claims and provider databases. Synchronizes data among multiple claims...system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This… more
- Centene Corporation (Sacramento, CA)
- …outcomes, cost-efficiency, and quality care. + Performance Management : Uses data analytics to track and monitor provider performance, offering actionable ... quality, and cost utilization. Participate in the development of network management strategies. Assists in the strategic...educate providers on use of tools and interpretation of data + Coaches new and less experienced Provider… more
- Humana (Detroit, MI)
- …orientations and onboarding, managing and responding to escalated issues for network providers, conducting ongoing education including provider training, ... to resolution. + Understanding of health insurance claims and ability to analyze data to resolve provider service issues. + Excellent written and verbal… more
- Corewell Health (Grand Rapids, MI)
- …and accuracy of product specific data for CMS service area expansion, network adequacy reporting and Medicaid Provider reporting. Performs gap analysis. + ... be analyzed and reviewed with the cooperation of the provider network community and internal departments. The...operations analyst is responsible for the oversight of the provider enrollment data and issue resolution arising… more
- Elevance Health (Columbus, OH)
- …for timely and accurate submission to the Provider Data Management area. + Ensure updates/changes for existing network providers are interpreted and ... equivalent background **Preferred Skills, Capabilities and Experiences:** + Centralized Data Management : Use a centralized system or...a centralized system or database to manage and store provider and system data . This improves … more
- FlexStaff (Bronx, NY)
- …and report on key performance metrics related to provider contracting and network development. + Provide training and guidance to internal teams regarding ... the on-boarding of new providers through the SCA process, data enter and update provider contracting tracker...on industry trends, regulatory changes, and best practices in provider contracting and healthcare management . Qualifications +… more