- Prime Therapeutics (Atlanta, GA)
- … network reporting for Prime and vendor's pharmacy networks composition to assess network adequacy , contracting gaps and compliance with regulations + ... Network Management policies + Create and manage network contracting campaigns with network ...achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to… more
- Molina Healthcare (Syracuse, NY)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... contracting /re- contracting of standard deals, maintaining network adequacy , issue escalations and JOCs on...Director in the negotiation of medical group/IPA and hospital contracting . * Advises Network Provider … more
- Molina Healthcare (Dallas, TX)
- **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... all claims and provider databases. Responsible for contracting /re- contracting of standard deals, maintaining network... contracting /re- contracting of standard deals, maintaining network adequacy , issue escalations and JOCs on… more
- Molina Healthcare (Long Beach, CA)
- …and must live in California _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... contracting /re- contracting of standard deals, maintaining network adequacy , issue escalations and JOCs on...negotiating with providers. * Participates in the evaluation of provider network and implementation of strategic plans… more
- CVS Health (TX)
- …move the providers though contracting processes in order to ensure meeting network adequacy requirements. This position can sit anywhere in the United ... States.** **Required Qualifications** * 5+ years of network contracting /management experience. * Ability to travel as needed (up to 25% travel) * 5 years of… more
- CareFirst (Baltimore, MD)
- …teams within Health Services to identify and address gaps in accessibility and network adequacy through recruitment and contracting . Ensures a balanced ... (KSAs)** + Understanding of multiple reimbursement methodologies used in healthcare provider contracting , including third party payment methodologies, delegated… more
- AmeriHealth Caritas (Manchester, NH)
- …provider network to meet member needs and ensure network adequacy . + Oversee provider contracting processes, ensuring compliance with pricing ... As the Manager of Provider Network , you will build and...minimum of 3 years of experience in managed care provider contracting and reimbursement is required, including… more
- Point32Health (ME)
- …Develop and maintain optimal provider networks. Assess, monitor, and manage network adequacy to meet federal and state regulations. Proactively identify and ... Responsibilities/Duties - what you will be doing (top five): Provider Network Strategy and Development + Develop...network gaps. + Collaborate with Enterprise Allied Health Contracting to ensure allied health and BH/SA networks and… more
- Molina Healthcare (GA)
- … Services. **PREFERRED EDUCATION:** Master's Degree **PREFERRED EXPERIENCE:** 6+ years in Provider Network contracting To all current Molina employees: ... develop and implement standardized provider contracts and contracting strategies. * Monitors and reports network adequacy to leadership for all lines of… more
- CVS Health (Workman, MN)
- …with internal and external stakeholders. + 3-5 years of experience in provider contracting . + Comprehensive understanding of Ohio's healthcare landscape. + ... strategic responses. + Design and implement systems to recruit providers, supporting network expansion and adequacy goals. + Conduct competitive analyses to… more
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