• Pharmacy Network Consultant Sr - Remote

    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
    Prime Therapeutics (10/04/25)
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  • Provider Contracts Manager HP - Core

    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 (09/25/25)
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  • Senior Specialist, Provider Contracts…

    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 (10/03/25)
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  • Provider Contracts Specialist (LOA's)

    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
    Molina Healthcare (07/25/25)
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  • Senior Network Provider Manager,…

    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
    CVS Health (09/26/25)
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  • Provider Contracting Specialist…

    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
    CareFirst (09/18/25)
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  • Manager Provider Network Management

    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
    AmeriHealth Caritas (08/14/25)
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  • Director, Network Contracting

    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
    Point32Health (10/02/25)
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  • Provider Contracts Director (Must reside…

    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
    Molina Healthcare (09/17/25)
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  • Manager, Payor Relations & Contracting

    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
    CVS Health (10/04/25)
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