- Mastercard (O'Fallon, MO)
- …and governments realize their greatest potential._ **Title and Summary** Director of Network Relations & Compliance Overview: The Director of Network ... working hours. The Director will be responsible for overseeing Third-Party Provider (TPP) relationships, analyzing operating rules, product offerings, and release… more
- Elevance Health (Los Angeles, CA)
- ** Network Relations Consult Sr** . **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... an accommodation is granted as required by law. The ** Network Relations Consult Sr** is responsible for...refresher training. + Researches issues that may impact future provider negotiations or jeopardize network retention. **Minimum… more
- Elevance Health (Columbus, OH)
- …maintains positive relationships with providers within a local health plan's LTSS/HCBS provider network . Researches and resolves operational issues. **How You ... provider training + Conducts virtual and in-person provider visits to support LTSS network +...to leadership and varied audiences preferred + Experience with provider relations preferred + Quality background preferred… more
- CVS Health (Frankfort, KY)
- …+ A minimum of 5 years' work experience in healthcare. + 3 to 5 years provider relations experience + Minimum of 3 years' experience in Medicaid Managed Care ... .** **Preferred Qualifications** + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, Provider Appeals & Disputes,… more
- CVS Health (Washington, DC)
- …with providers and partners at all levels. + 3 to 5 years of provider relations experience- non-standard relationships with providers with exposure to benefit ... activities. Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets.… more
- CVS Health (Atlanta, GA)
- …geographic territory responsible for overall maintenance and territory management of the provider network , as a functional subject matter expert, demonstrating a ... of Aetna's Dental Products and market position. Negotiation of contract language and provider compensation. Review quality and service reports with provider and… more
- Molina Healthcare (Houston, TX)
- …Remote and must live in Texas _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...primary point of contact between Molina Healthcare and contracted provider network . In partnership with Director, manages… more
- Molina Healthcare (Vancouver, WA)
- **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...primary point of contact between Molina Healthcare and contracted provider network . They are responsible for … more
- Molina Healthcare (WI)
- **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...primary point of contact between Molina Healthcare and contracted provider network . They are responsible for … more
- Cardinal Health (Hagatna, GU)
- …organization. **_Responsibilities:_** + Maintain up to date credentials for entire network of participating health plans + Cultivate and maintain on-going payer ... updates when required + Report results and outcomes of network status to management at regular intervals + Respond...third party/managed care requests in a timely manner + Provide existing customers and third-party vendors with the best… more
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