- The Cigna Group (Atlanta, GA)
- **WORK LOCATION: Atlanta, GA** The ** Director ** ** Provider Contracting Network Management** serves as an integral member of the Provider ... Contracting Team and reports to the AVP, Provider Contracting . This role assists in developing...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- Elevance Health (Atlanta, GA)
- ** Provider Network Management Director ** **Location:** 740 W Peachtree St. NW. Atlanta GA. This role requires associates to be in-office 3 days per week, ... an accommodation is granted as required by law_ The ** Provider Network Management Director ** develops...projects with significant impact. * May assist management in network development planning. * May provide work… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a team designing and executing new solutions. The position requires ... business and system requirements of customers as it pertains to contracting , network management and credentialing. + **Knowledge/Skills/Abilities** +… more
- Molina Healthcare (Atlanta, GA)
- …and must live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... contracts and contracting strategies. **Job Duties** Manages the Plan's Provider Contracting functions and team members. Responsible for leading the daily… more
- Molina Healthcare (Atlanta, GA)
- …regulators in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other ... business and system requirements of customers as it pertains to contracting , network management and credentialing. **Knowledge/Skills/Abilities** * Strategically… more
- CVS Health (Atlanta, GA)
- …complexity of operations in these areas. Role will support VBC contracting efforts, stronger payer- provider relationships and improved financial performance. ... the most complex/high value initiatives and/or highest risk and revenue generating provider systems, network and value-based relationships. Ensures that assigned… more
- Highmark Health (Atlanta, GA)
- …cross organizational programs and projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2 years Understanding of ... to drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark… more
- ChenMed (Atlanta, GA)
- …other clinical issues + Familiarity with healthcare network strategy, including network development, value-based care contracting , provider relations and ... expanding and we need great people to join our team. The Regional Medical Director (RMD) is a developmental, pathway role to Market Chief Medical Officer which is… more
- Molina Healthcare (Atlanta, GA)
- …**I** **E** **N** **C** **E:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, Medicaid, ... as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices,… more
- Molina Healthcare (Atlanta, GA)
- …etc. **PREFERRED EXPERIENCE:** + Peer Review, medical policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS, ... as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices,… more