- Elevance Health (Atlanta, GA)
- ** Provider Contract Cost of Care Consultant** **Location** : This position will work a hybrid model (remote and office). The Ideal candidate will live ... 50 miles of one of our Elevance Health PulsePoint locations. The ** Provider Contract Cost of Care Consultant** will be responsible for providing… more
- Avera (Des Moines, IA)
- …Forward for you and our patients. Work where you matter.** **A Brief Overview** The Provider Contract Manager is a critical member of Avera Health Plans (AHP) ... implementation of broad based, tiered, and narrow network products and value-based contract arrangements. Also lead medical cost reduction programs to identify… more
- Corewell Health (Grand Rapids, MI)
- …understanding of contracts and passion for problem solving? Priority Health is seeking a Provider Contract Specialist to take ownership of provider contracts ... guidance in others. Essential Functions + Contributes to the contract development and negotiation process for provider ...contracts and contract information in the system contract database. + Provide effective oversight of… more
- The Cigna Group (Cleveland, OH)
- …total medical cost and quality. + Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...partners. + Intimate understanding and experience with hospital, managed care , and provider business models. + Team… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Provider Contract Specialist (Remote Option within Service Area) ** Cost Center:** 682891544 SHP- ... day shifts (United States of America) **Job Description:** **JOB SUMMARY** The Provider Contract Specialist works in cooperation with the Contracting Manager… more
- CVS Health (Hartford, CT)
- …it all with heart, every single day. We are seeking a **Senior Manager of Provider Contract & Pricing Testing** to join our expanding Testing Center of ... experience managing quality assurance projects. + 5+ years of experience in provider contract testing, claims adjudication systems, quality assurance, or related… more
- Centene Corporation (Providence, RI)
- …risk, shared savings, and global capitation. + Analyze provider performance against contract benchmarks (eg, total cost of care , Stars measures) and ... Dual Eligible Special Needs Plans (D-SNPs). This role is critical in analyzing provider performance, modeling contract terms, and generating insights to guide… more
- UNC Health Care (Fuquay Varina, NC)
- …healthcare team in accordance with privileges approved by the credentialing committee to provide high-quality, cost -effective care to patients within the ... the health and well-being of the unique communities we serve. Join our growing UNC Urgent Care provider team! This is an employed position with UNC Rex and is a… more
- AmeriHealth Caritas (Raleigh, NC)
- …pricing, payment methodologies, and state/federal requirements. + Cultivate high-performing, cost -effective provider networks that support access, quality, and ... preferred. + A minimum of 10 years of progressive experience in managed care with direct accountability for provider contracting, reimbursement strategy, and… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …understanding of contract language * Strong understanding of professional provider cost structures and reimbursement methodologies * Sound knowledge of ... new relationships and contracts as needed with providers and re- contract with existing providers to ensure cost ...as appropriate to incorporate a sound strategic approach to provider network development. The Contract Manager is… more