- Humana (Columbus, OH)
- …work experience. + 8 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience + ... relationship across such areas as financial performance, incentive programs, quality and clinical management , population health, data sharing, connectivity,… more
- CACI International (Las Cruces, NM)
- Network Management Systems (NMS) Operations Tier 3 Job Category: Information Technology Time Type: Full time Minimum Clearance Required to Start: TS/SCI with ... Continental US * * * **The Opportunity** : We are seeking an experienced Network Management Systems (NMS) Engineer to oversee the operations of the production… more
- Centene Corporation (Jefferson City, MO)
- …**.** Five or more years of managed care or medical group experience, provider relations, quality improvement, utilization management , or clinical ... level of care to our members. Participate in the development of network management strategies. Creates strategic initiatives for performance improvement. +… more
- Centene Corporation (New Port Richey, FL)
- …of managed care or medical group experience, provider relations, quality improvement, claims, contracting utilization management , or clinical operations. ... network performance opportunities and solutions, and consultative account management and accountability for issue resolution. Drive optimal performance in… more
- Evolent (Hagatna, GU)
- …Strategic Account teams and payer clients to align priorities and deliver high- quality provider network engagement, performance reporting, and present ... performance within your territory. You will design and execute strategies that elevate provider performance, enhance care quality , and drive improved outcomes in… more
- University of Colorado (Aurora, CO)
- …+ The APP works independently within the multidisciplinary team to provide quality inpatient care and disease management for a variety of pediatric inpatient ... of Colorado Network of Care, including clinical obligations providing pediatric provider coverage at Vail Health in a remote, community hospital setting. This… more
- CareFirst (Baltimore, MD)
- …and work activities/deliverables that week._** **ESSENTIAL FUNCTIONS:** + Oversight and management of a portfolio of provider -related projects and initiatives. ... **Resp & Qualifications** **PURPOSE:** This position is responsible for the daily management , coaching and development of the team; managing key network … more
- CVS Health (Lincoln, NE)
- …based groups/systems in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality and ... Aetna and CVS departments to identify initiatives to improve physician performance and quality of care provided to our members. Recruit's providers as needed to… more
- The Cigna Group (Fort Worth, TX)
- …plays a key role in ensuring the accuracy, completeness, and timeliness of provider network data required for regulatory approval and compliance. **Primary ... Responsibilities:** + Project management coordinating with multiple matrix partners and compiling, formatting,...with multiple matrix partners and compiling, formatting, and validating provider network data for DOI and CMS… more
- Elevance Health (Woodbridge, NJ)
- …Capabilities and Experiences:** + Strongly preferred MBA degree. + Proven Network provider and contracting experience including Value-Based Care, Fee-for-Service ... enterprise-wide initiatives to include local cost of care and trend management , innovative provider contracting, implementation of cutting-edge payment programs,… more