- Elevance Health (Mason, OH)
- ** 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
- Molina Healthcare (Dayton, OH)
- …4 years provider contract support or negotiation experience in the health care field including, but not limited to, provider 's office, managed care ... Duties** This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and… more
- Elevance Health (Mason, OH)
- Provider Success Consultant Sr. (Ohio Market) **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... This position will require the candidate to travel to provider locations in Ohio at a minimum of 50%...at a minimum of 50% of the time. **The Care Consultant Sr.** is responsible for fostering long-term partnerships… more
- Elevance Health (Cincinnati, OH)
- …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 (Dayton, OH)
- …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
- Molina Healthcare (Dayton, OH)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- Elevance Health (Mason, OH)
- …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
- Molina Healthcare (Dayton, OH)
- …goals of the department and organization. + Oversees the maintenance of all provider contract information and templates and ensures that all negotiated contracts ... and implement provider contracting and service strategies to contain unit cost , improve member access and enhance provider satisfaction with the Plan.… more
- Molina Healthcare (Dayton, OH)
- …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
- Elevance Health (Mason, OH)
- **Behavioral Health Care Manager II** Carelon Behavioral Health **_Virtual_** **_: _** _ _ This role enables associates to work virtually full-time, with the ... depression, and insightful analytics to improve the delivery of care . The **Behavioral Health Care Manager II**...access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines… more
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