• Provider Contract Cost

    Elevance Health (Des Moines, IA)
    ** Provider Contract Cost of Care Consult Senior / VBC** **Location:** This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consult...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
    Elevance Health (10/31/25)
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  • VP, Ltss - Health Care Operations (Remote)

    Molina Healthcare (Cedar Rapids, IA)
    …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
    Molina Healthcare (09/25/25)
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  • Lead Analyst, Healthcare Analytics- Managed…

    Molina Healthcare (Des Moines, IA)
    …claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and ... cost containment reports and makes recommendations based on relevant...materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of… more
    Molina Healthcare (09/11/25)
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  • Care Review Clinician (LVN / LPN)

    Molina Healthcare (Cedar Rapids, IA)
    …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more
    Molina Healthcare (10/22/25)
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  • Field Care Manager, LTSS - Experienced…

    Molina Healthcare (West Union, IA)
    …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... to determine the types of services we need to provide and managing their care until they...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. If licensed,… more
    Molina Healthcare (10/31/25)
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  • Care Manager (non-RN)- Must Reside in

    Molina Healthcare (Iowa City, IA)
    …ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job ... JOB DESCRIPTION Job SummaryProvides support for care management/ care coordination activities and collaborates...licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandates. * Valid… more
    Molina Healthcare (10/29/25)
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  • Dispensing Pharmacist - Long Term Care

    CVS Health (Urbandale, IA)
    …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... heart, each and every day. **Position Summary** As a pharmacist for our Long-Term Care Pharmacy, you will work in an exciting, dynamic and fast paced environment,… more
    CVS Health (10/11/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Iowa City, IA)
    …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. * Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
    Molina Healthcare (10/31/25)
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  • Senior Analyst, Network Strategy, Pricing…

    Molina Healthcare (Davenport, IA)
    …underperforming and problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by ... financial impact. + Work independently to support and validate Provider Network contracting and unit cost management...Provides peer review of team members' presentations for total cost of care and profit improvement initiatives… more
    Molina Healthcare (10/25/25)
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  • Director Reimbursement Design & Market Evaluation

    Highmark Health (Des Moines, IA)
    …and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...of healthcare + Comfort and with real-time calculations of cost , membership, etc. (ie, "back of the envelope" estimations)… more
    Highmark Health (10/29/25)
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