- Humana (Albany, NY)
- …Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing ... will be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities. They will work closely… more
- Molina Healthcare (Gulfport, MS)
- …oversight. Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts ... lives in Mississippi _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and… more
- The Cigna Group (Oakland, CA)
- …Berkeley, San Ramon, Concord, Pleasant Hill, CA areas are preferred** The ** Manager , Provider Contracting Network Management** serves as an integral member ... and organizations required.** + Experience in developing and managing key provider relationships + Knowledge of complex reimbursement methodologies, including… more
- The Cigna Group (Sunrise, FL)
- The ** Provider Contracting Manager ** serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting. This ... and organizations required.** + Experience in developing and managing key provider relationships + Knowledge of complex reimbursement methodologies, including… more
- AmeriHealth Caritas (Washington, DC)
- …and communication for network providers and acts as a liaison with the provider community. + Ensures compliance with pricing guidelines established by AMC ... + Resolves difficult complex contract issues to ensure that provider contracts are in compliance with state,...insurance, ACA Exchange Business & DSNPs. + 5 years provider contracting/ reimbursement experience in healthcare setting. +… more
- Molina Healthcare (Caldwell, ID)
- …effective and marketable providers. **KNOWLEDGE/SKILLS/ABILITIES** + In conjunction with Director/ Manager Provider Contracts, negotiates high priority physician ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets and… more
- CareFirst (Baltimore, MD)
- …+ Proficient in Microsoft Office programs. + Deep understanding of multiple reimbursement methodologies used in healthcare provider contracting. + Knowledge of ... day to day activities regarding network development. Responsibilities include provider recruiting/contracting for commercial business and government programs, new… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview** The Manager Provider Network Reporting manages a team of Data Analysts responsible for meeting provider network reporting needs related to ... and implementation of business analysis and reporting needs to assure accuracy, compliance and delivery for RFPs, new and emerging markets, existing LOBs and… more
- CVS Health (Frankfort, KY)
- …health providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance , quality, ... financial goals and cost initiatives. Collaborates cross-functionally to develop provider compensation and pricing strategies and manages contracts through language… more
- J&J Family of Companies (Santa Clara, CA)
- …with Market Access, Health Economics, Medical Affairs, and Compliance teams. + Provide field insights on reimbursement trends and OBL operational models. + ... is currently seeking the best talent for a Field Reimbursement Manager within the Johnson & Johnson...across Shockwave's portfolio of products **Essential Job Functions** **1. Reimbursement Tools & Materials** + Provide input… more