- Humana (Boston, MA)
- …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
- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA-Network Contracting **Position Summary:** Under the direction of the Senior Contract Manager , Provider Contracting, the Senior Provider Contract ... healthcare services. Essential Duties & Responsibilities: + Develop, negotiate, manage and maintain provider contracts for a set of provider types, such as… more
- The Cigna Group (Bloomfield, CT)
- The Provider Data Manager is a strategic leadership role responsible for driving data quality initiatives, managing compliance reporting, and leading a ... efforts and ensure alignment with enterprise standards. + Analyze provider demographic, contract, and reimbursement data to... provider data management systems (eg, HCPM, CPF-Central Provider File, PRDS, Inventory Manager , & industry… more
- Modivcare (Mechanicsville, VA)
- …opportunity may be the right fit for you! Modivcare is looking for an experienced Provider Relations Manager to join our team! This position is responsible for ... areas, various company departments, and outside resources as requested. Please note, the Provider Relations Manager will be expected to routinely travel within… more
- Molina Healthcare (Buffalo, NY)
- …oversight. Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the...overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.… more
- AmeriHealth Caritas (Detroit, MI)
- … satisfaction surveys and lead improvement efforts based on feedback. **Quality & Compliance ** + Monitor provider compliance with claims policies and ... **Role Overview:** The Manager of Provider Network Management oversees...operations of the Network Management department, including staff supervision, provider contracting, recruitment, and compliance . This role… more
- Molina Healthcare (Warren, MI)
- …live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting (Long Term Support Services, LTSS) jobs are responsible for ... overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations....contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider … more
- The Cigna Group (Los Angeles, CA)
- …Glendale, CA market. Must live in the Glendale/Los Angeles, CA area.** The ** Manager , Provider Contracting Network Management** serves as an integral member of ... and organizations required.** + Experience in developing and managing key provider relationships + Knowledge of complex reimbursement methodologies, including… more
- The Cigna Group (Erie, PA)
- **WORK LOCATION: Pittsburgh, PA - Western PA/West Virginia market** The ** Manager , Provider Contracting Network Management** serves as an integral member of the ... 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