- Molina Healthcare (Albuquerque, NM)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Rio Rancho, NM)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (NM)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Evolent (Santa Fe, NM)
- …Account teams and payer clients to align priorities and deliver high-quality provider network engagement, performance reporting, and present to health plans ... OR THE WEST REGION We are seeking a strategic and collaborative Associate Director , Provider Engagement to lead our oncology-focused provider engagement… more
- Sedgwick (Santa Fe, NM)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Provider Network Specialist **PRIMARY PURPOSE** **:** To ensure clients and ... MCO provider on physician credentialing, MCO additions and removals, network and problematic issues. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **ARE YOU AN… more
- Acxiom (Albuquerque, NM)
- As the Director , Campaign Management , Retail & Commerce Networks Acxiom's Commerce & Retail Media Network Practice, you will play a critical role in ... channels. In this role, you will focus on yield optimization, campaign management , media activation, and performance reporting, ensuring every campaign is planned… more
- Cardinal Health (Santa Fe, NM)
- …we can get life-changing therapies to patients who need them-faster.** The Director of Business Development, Patient Hub Services, is responsible for business ... of Access and Patient Support, Clinical Services and Reimbursement Services. The Director will build key customer relationships to uncover customer needs to align… more
- Genesis Healthcare (NM)
- …Responsibilities Make a difference in patient care by joining our team as the Director of Clinical Risk Management . You will champion patient safety and quality ... Overview Are you a Director of Nursing (DON) in LTC ready to...your career to the next level in Clincail Risk Management ? Do you have existing expeirnce in clincal compliance… more
- Highmark Health (Santa Fe, NM)
- …cross organizational programs and projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2 years Understanding of ... provider contract documents and overall contract management process **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Excellent… more
- Molina Healthcare (Albuquerque, NM)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more