- CACI International (Sterling, VA)
- Network Problem Management Quality ...Develop and maintain quality standards for problem management processes + Provide training and guidance ... * * * **The Opportunity** : We are seeking an experienced ITIL Network Problem Management Quality Assurance Lead to ensure the effectiveness and efficiency… more
- CACI International (Springfield, VA)
- Network Capacity Management Quality Analyst Job Category: Information Technology Time Type: Full time Minimum Clearance Required to Start: TS/SCI with ... forecasts for network services + Conduct regular quality audits of capacity management processes and...management + Participate in capacity planning meetings and provide expert insights + Provide data-driven insights… more
- UPMC (Pittsburgh, PA)
- …optimal clinical and quality outcomes for members. + Works with Member Services, Network Management and Quality Management staff to assure that ... a Licensed Professional Care Manager for the Acute Care Management Team in Allegheny County. This role will work...on advanced-level knowledge of the service delivery system, the provider network , member services policies, members' rights… more
- CVS Health (Hartford, CT)
- …expert to assist the internal GLOBAL VIP CLIENT account management team with network and TPA questions or inquiries. Provide support to peers and colleagues ... with providers according to prescribed guidelines in support of global and regional network strategies. Expand International provider network by contracting… more
- The Cigna Group (Los Angeles, CA)
- …Glendale, CA market. Must live in the Glendale/Los Angeles, CA area.** The **Manager, Provider Contracting Network Management ** serves as an integral member ... management of the day to day contracting and network management activities for a local given...and manages initiatives that improve total medical cost and quality . + Drives change with external provider … more
- The Cigna Group (Fort Lauderdale, FL)
- …need to work in the office or visit Providers 3 days per week The **Manager, Provider Contracting Network Management ** serves as an integral member of the ... management of the day to day contracting and network management activities for a local given...and manages initiatives that improve total medical cost and quality . + Drives change with external provider … more
- UPMC (Pittsburgh, PA)
- …of care and maximal use of community supports and resources. + Works with Member Services, Network Management and Quality Management staff to assure that ... problem solving based on sophisticated knowledge of in-plan services, the provider network , member services policies, members' rights and responsibilities,… more
- AmeriHealth Caritas (Manchester, NH)
- …+ Lead strategic planning, development, and management of the hospital and physician provider network to meet member needs and ensure network adequacy. + ... will build and nurture strategic provider partnerships that strengthen our network , drive innovation, and ensure high- quality care for our communities. They… more
- Molina Healthcare (Madison, WI)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Corewell Health (Grand Rapids, MI)
- …Qualifications Required + Bachelor's Degree + 5 years of relevant experience of either provider network management experience, health care insurance or other ... Manage contract success through analysis of monthly reports + Provide mitigation solutions for gap closure and quality...E Beltline - Grand Rapids Department Name PH - Provider Network Management Employment Type… more
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