- CVS Health (Richmond, VA)
- …time. **Preferred Qualifications** + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, Provider Appeals & Disputes, ... plan design, contract language, service, claims or compensation issues, and provider education needs. + Optimizes interactions with assigned providers and internal… more
- CVS Health (Springfield, IL)
- …And we do it all with heart, each and every day. **Position Summary** The Medicaid Network Provider Relations Manager oversees our Medicaid Provider ... systems). Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets.… more
- Molina Healthcare (GA)
- …must live in Georgia _** **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network ... and in compliance with all relevant federal, state and local regulations. Provider Network staff are the primary point of contact between Molina Healthcare and… more
- CVS Health (NY)
- …- Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. May ... large group or hospital systems) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative… more
- Molina Healthcare (Detroit, MI)
- …Remote and must live in Michigan _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... and deploys strategic network planning tools to drive Provider Relations and Contracting Strategy across the enterprise. * Facilitates strategic planning… more
- Elevance Health (Hanover, MD)
- … preferred. + Training development and presentation experience strongly preferred. + Provider relations , and network contracting experience strongly ... ** Network Relations Specialist MD Market** **Location...providers and practice managers within Maryland's local health plan's provider delivery system. Researches and resolves operational issues. **How… more
- Elevance Health (Mason, OH)
- …behavioral health, long term services and supports, and psychosocial needs._ ** Network Relations Consultant Senior (Value-Based Program Specialist) - MyCare ... Monday-Friday, 8:00 AM - 5:00 PM Eastern Time The ** Network Relations Consultant Senior** (Value-Based Program Specialist)...as needed. + Researches issues that may impact future provider negotiations or jeopardize network retention. +… more
- AmeriHealth Caritas (Detroit, MI)
- **Role Overview:** The Manager of Provider Network Management oversees the day-to-day operations of the Network Management department, including staff ... and supports the healthcare needs of plan members. The manager also leads initiatives to improve provider ...and auto-adjudication processes. ** Provider Recruitment, Retention, & Relations ** + Ensure network adequacy in accordance… more
- Elevance Health (Cleveland, OH)
- …maintains positive relationships with providers within a local health plan's LTSS/HCBS provider network . Researches and resolves operational issues. **How You ... provider training + Conducts virtual and in-person provider visits to support LTSS network +...to leadership and varied audiences preferred + Experience with provider relations preferred + Quality background preferred… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Provider Relations Representative is responsible for establishing and maintaining positive relationships with various ... administrator operations such as eligibility, prior authorization, claims administration and provider network administration. Familiarity with managed care and… more