- Elevance Health (Atlanta, GA)
- ** Provider Contract / Cost of Care Consultant** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Provider Contract / Cost of Care...or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- Centene Corporation (Atlanta, GA)
- …account management and accountability for issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization. + Serve ... and align to performance-based agreements that incentivize better patient outcomes, cost -efficiency, and quality care . + Performance Management: Uses data… more
- Elevance Health (Atlanta, GA)
- …to the market. + Provide analytical support for strategic initiatives, such as contract negotiations, provider network optimization, and total cost of ... strong communication and interpersonal skills. + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Molina Healthcare (Atlanta, GA)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Elevance Health (Atlanta, GA)
- …VISA sponsorship._ The **Senior Health Economics Analyst** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses ... Medical Directors, contract negotiators and management on cost of care issues to help reduce...modifications as applicable. + Recommends standardized practices to optimize cost of care . + Educates provider… more
- Guidehouse (Atlanta, GA)
- …Will Do** **:** Guidehouse's Health Strategy team advises and helps Payer/ Provider clients execute on strategic planning, business model strategy, operating model ... strategy / design, competitive agility, enterprise transformation, cost reductions / ZBx, M&A, service line strategy, product strategy, and innovation. Strategy at… more
- Intermountain Health (Atlanta, GA)
- …behavioral, and social needs of members while promoting self-management, quality, and cost -effective outcomes. **Essential Functions** + The nurse care manager ... This position is responsible for developing, documenting and implementing care plans, which will provide the appropriate...and consistent with goals and objectives of referral, payer contract , or established care processes. + Maintains… more
- Molina Healthcare (Atlanta, GA)
- …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
- Highmark Health (Atlanta, GA)
- …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
- CVS Health (Atlanta, GA)
- …for VBC contracts, working with both internal and external partners, to provide medical cost and outcomes focused analytical research, financial modeling, ... against business and team objectives + Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets… more