- Elevance Health (Waukesha, WI)
- ** Cost of Care / Provider Contracting Data Analyst** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... an accommodation is granted as required by law. The ** Cost of Care / Provider Contracting...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Waukesha, WI)
- …for providing the highest level of analytical support to the Cost of Care and/or Provider Contracting organizations. **How you will make an impact:** ... cost of care . + Educates provider contractors on contracting analytics from a...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Humana (Madison, WI)
- …the health of the communities we serve. The Regional Vice President will also provide executive leadership to Provider Contracting , Provider Education ... Develop and lead efforts re: continuous improvement for unit cost strategy. + Ensure access to care ...clinical resources. + Provide leadership to regional provider engagement, contracting , and operations teams. +… more
- Molina Healthcare (Racine, WI)
- …previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** ... **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible...with VBC providers that result in high quality and cost -effective care . Maintains tracking system and publishes… more
- Highmark Health (Madison, WI)
- …Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population health ... a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care...projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2… more
- Molina Healthcare (Racine, WI)
- …claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and ... cost containment reports and makes recommendations based on relevant...departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
- Molina Healthcare (WI)
- …health plans on the financial impact. + Work independently to support and validate Provider Network contracting and unit cost management activities through ... problematic contracts. Supports multi-dimensional pricing strategies to drive down total cost of care and minimize variation in cost by leveraging… more
- CDM Smith (Racine, WI)
- … cost estimates and supporting analysis in coordination with government cost estimators and contracting officers. * Participate in pre-construction meetings, ... and prepares technical reports and/or project status reports. * Provide engineering judgment for field modifications, non-conformance issues, value engineering… more
- Prime Therapeutics (Madison, WI)
- …address changing market demands and ensure Prime is delivering the highest quality and lowest cost of care to its members and related client messaging as well as ... pipeline to capitalize on savings through effective negotiation and contracting + Develop strong working relationships and communication at...different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for… more
- Molina Healthcare (Green Bay, WI)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost -effective based on the severity ... that support ongoing improvements of clinical operations functions and promote quality cost effective health care for Molina members. + Develops initiatives… more