- Molina Healthcare (TX)
- …and efficient business results. * Trains and monitors newly hired Contract Specialist (s). * Participates in other contracting related special projects as ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to… more
- Molina Healthcare (Miami, FL)
- **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial and ... regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting /re- contracting of VBCs, issue escalations and JOCs on… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... as appropriate, DRG recoupments/downgrades, and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information… more
- CareFirst (Baltimore, MD)
- …submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge to build the effective guides and resources for ... and integration of medical codes across policies and platforms. The Senior Coding Analyst partners with medical policy analysts, configuration teams, and… more
- Valvoline Global (KY)
- **Job Purpose** The Procurement Specialist will have spend segment responsibility and ownership for part certain categories of the Indirect Purchasing vendor ... This position will contribute to vendor selection process, vendor approval and contracting for the category. This position will facilitate strategic sourcing through… more
- Molina Healthcare (Rockford, IL)
- Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role is remote with a high preference for candidates who reside in Illinois. ... The Sr Specialist in our Government Contracts will be responsible for...experience-** + Live in Illinois and are familiar with Managed Care in Illinois and how HHF operates. +… more
- Molina Healthcare (West Valley City, UT)
- …(eg, Provider Services/Provider Inquiry Research & Resolution, Provider Contracting /Provider Relationship Management). + Provides timely, accurate generation and ... equivalent combination of education and experience **Required Experience** + 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider… more
- Molina Healthcare (Mesa, AZ)
- …requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + ... or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and presentation skills;… more
- BayCare Health System (FL)
- …PM (may vary) + **Days:** Monday - Friday The Credentialing and Provider Enrollment Specialist Senior will work in a remote role. Responsibilities: + Responsible ... errors and issues by coordinating with the plans/payors, the CBO and the Managed Care contracting department. + This includes ensuring the provider's information… more
- Merck (North Wales, PA)
- **Job Description** The Central Contract Services (CCS) Senior Specialist will function as a vital member of the broader Integrated Account Management team ... to develop, implement, and execute contract strategies. The CCS Senior Specialist will also be responsible for...and Excel **Preferred** + 3+ years business experience in Managed Care Contracting or Pharmaceutical industries. **Required… more
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