- Elevance Health (Durham, NC)
- ** Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration ... granted as required by law. The ** Provider Contract Cost of Care Analyst...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- UNC Health Care (Raleigh, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... guidelines and other regulatory and accreditation standards. **Join our growing UNC Urgent Care provider team! This is an employed position with UNC Rex… more
- UNC Health Care (Butner, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... problem-solving, decision-making, and evaluating clinical/system issues and models of care . Leads interdisciplinary teams to provide integrated delivery… more
- UNC Health Care (Morrisville, NC)
- … cost models for departments, service lines, procedures, and payers. + Provide actionable insights to support pricing strategies, contract negotiations, and ... the unique communities we serve.** **Summary:** This position leads the system-wide cost accounting and decision support function for an integrated healthcare system… more
- Prime Therapeutics (Raleigh, NC)
- …Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose ... purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven...the future of pharmacy with us. **Job Posting Title** Provider Relations Manager - Remote **Job Description** The Manager… more
- UNC Health Care (Morrisville, NC)
- …to develop plants to execute such projects. The HCS Director of Managed Care Contracting will optimize the organization's contract performance with its ... . This position will utilize AI-enabled platforms to centralize payer- provider agreements, automate extraction of key contract ...at least 7 years of progressive experience in managed care contracting within a healthcare provider or… more
- Humana (Raleigh, NC)
- …of our caring community and help us put health first** The Autism Care Navigator, (ASN) collaborates and oversees member assessment, planning, facilitation, care ... needs through communication and available resources to promote quality, cost -effective outcomes. Coordinate medical, behavioral and other services for beneficiaries… more
- Humana (Raleigh, NC)
- …us put health first** The IT Vendor Management Lead - EMR, Clinical Care Delivery & Home Health Platforms supports strategic suppliers that underpin clinical ... workflows, care delivery systems, electronic health/medical records (EHR/EMR), and home health operations. This role requires deep understanding of health-tech… more
- Elevance Health (Raleigh, NC)
- …for overseeing and monitoring healthcare services to insure quality, compliance, and cost -effectiveness. Coordinate care across providers and settings to improve ... plans and ensure they are appropriate, high quality, and cost -effective. + Coordinate care between delegated ...determinants of health, to meet the member's needs and provide patient education. + Escalate member crises, or quality… more
- Elevance Health (Hayesville, NC)
- …applicable state law and contract . **How you will make an impact:** + Provide integrated whole-person Care Management under the CFSP Care Management ... **CFSP Managed Care Coordinator** **Sign-on Bonus: $2500** **We are currently...of members with chronic illnesses, co-morbidities, or disabilities for cost -effective and efficient service utilization. + Set short- and… more