- CVS Health (Springfield, IL)
- …it all with heart, each and every day. **Position Summary** The Medicaid Network Provider Relations Manager oversees our Medicaid Provider Experience ... with others at all levels * Minimum of 2 years' experience with Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider… more
- CVS Health (Coral Gables, FL)
- …- Miami Dade or Broward County** **Preferred Qualifications** + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, ... by assisting with or responding to complex issues regarding Medicaid policies and procedures, plan design, contract language, service,...Provider Appeals & Disputes, and Network Performance Standards. + Experience in Medical Terminology, CPT,… more
- Molina Healthcare (GA)
- …in Georgia _** **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, ... and in compliance with all relevant federal, state and local regulations. Provider Network staff are the primary point of contact between Molina Healthcare and… more
- Elevance Health (Mason, OH)
- …behavioral health, long term services and supports, and psychosocial needs._ ** Network Relations Consultant Senior (Value-Based Program Specialist) - MyCare ... **Shift & Hours:** Monday-Friday, 8:00 AM - 5:00 PM Eastern Time The ** Network Relations Consultant Senior** (Value-Based Program Specialist) is responsible for… more
- Molina Healthcare (Detroit, MI)
- …**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : * 4-6 years provider contract network relations and management experience in a managed healthcare ... and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development,… more
- Molina Healthcare (San Francisco, CA)
- **Job Description** **Job Summary** Responsible for leading provider network operations, contracting support, policies and procedures, and provider communications. ... aligning with Molina Healthcare's mission and strategic goals. Partners with network contracting, operations, government contracts, compliance, and systems teams to… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Provider Relations Representative is responsible for establishing and maintaining positive relationships with various ... such as eligibility, prior authorization, claims administration and provider network administration. Familiarity with managed care and self-insurance products and… more
- AmeriHealth Caritas (Detroit, MI)
- **Role Overview:** The Manager of Provider Network Management oversees the day-to-day operations of the Network Management department, including staff ... to enhance claims submission and auto-adjudication processes. **Provider Recruitment, Retention, & Relations ** + Ensure network adequacy in accordance with state… more
- Elevance Health (Las Vegas, NV)
- **Be Part of an Extraordinary Team** **Senior Provider Network Manager ** **Location:** NV-LAS VEGAS, 9133 W RUSSELL RD **Hybrid** : **This role requires ... unless an accommodation is granted as required by law._ The **Senior P** **rovider Network Manager ** is responsible for developing the provider network … more
- Bassett Healthcare (Cooperstown, NY)
- …340B Drug Pricing Program for all qualified entities throughout the Bassett Health Network . The 340B Manager serves as the primary institutional compliance ... the best quality of life possible. What you'll do Reporting to the Chief Pharmacy Officer, the 340B Manager is responsible for compliance and administration of the… more
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