- Humana (Columbus, OH)
- …and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts. ... The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of… more
- Elevance Health (Cincinnati, OH)
- …or jeopardize network retention. + Serves as a knowledge expert regarding LTSS provider contracting and has a broad understanding of LTSS credentialing ... based concepts and fee schedules is strongly preferred. + Experience with LTSS provider contracting and credentialing is a huge plus, and strongly preferred.… more
- CVS Health (Columbus, OH)
- …to achieve contracting targets and manage medical costs through effective provider contracting . * Optimize interaction with assigned providers and internal ... strategic, traditional contracts and value-based relationships. Role is for national behavioral health contracting and strategic partnerships** Key deliverables… more
- Elevance Health (Mason, OH)
- ** Provider Contract Specialist Manager** Carelon Behavioral Health _Location: Hybid 1: This role requires associates to be in-office 1 - 2 days per week, ... and facility contracts across value based and fee for service agreements for provider solutions. + Works directly with contracting directors and managers to… more
- Elevance Health (Mason, OH)
- …gaps and ad-hoc training needs. + Works collaboratively with Network Support, Contracting , and external stakeholders to ensure LTSS provider qualification ... education and internal health plan support to mitigate issues related to provider operations, contracting and provider claims submissions. + Mentors,… more
- Highmark Health (Columbus, OH)
- … professional billing, facility Patient Financial Services, HIM, Internal Audit, Professional /Facility Reimbursement or Provider Contracting **LICENSES or ... **ESSENTIAL RESPONSIBILITIES** + Performs investigations into potential and existing provider and member fraud, waste and abuse activities.Identifies parties… more
- CenterWell (Columbus, OH)
- …our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate ... network management, and payment frameworks (eg capitation, partial risk, direct contracting ) + Population health minded physician with an understanding of, and… more
- CoreCivic (Youngstown, OH)
- …supervisors, assign, train, supervise and evaluate the work of staff who provide security and security-related functions at the facility; interview and recommend ... + Communicate effectively and coherently to administration, staff, inmates/residents, contracting agency, local governmental law enforcement agencies, visitors, the… more