- Elevance Health (Waukesha, WI)
- ** Provider Contract Cost of Care Consult Senior / VBC** **Location:** This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consult...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Molina Healthcare (Milwaukee, WI)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads...department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates.… more
- Molina Healthcare (Green Bay, WI)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- American Family Insurance - Corporate (Madison, WI)
- …location._ _Relocation support is offered for eligible candidates._ The Lead Source-to- Contract (S2C) Process Owner is responsible for leading the development, ... implementation, and maintenance of the Procurement Source-to- Contract (S2C) processes. You will look to streamline processes,...proposed and ongoing projects based on value, risk, effort, cost and strategic alignment. + You will develop and… more
- Option Care Health (Madison, WI)
- …us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care , so we are investing in a culture that ... infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality...resulting in high quality outcomes at a significantly reduced cost . Option Care Health has more than… more
- Molina Healthcare (Kenosha, WI)
- …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
- Veterans Affairs, Veterans Health Administration (Kenosha, WI)
- … care community. - Promotes a practice environment that empowers staff to provide compassionate and efficient care . - Demonstrates a commitment to Equal ... incumbent is the Department Head (DH) for VA Primary Care , for Evanston CBOC, for Kenosha CBOC, or for...or long-term absence of one, the remaining DHs shall provide supervisory coverage as necessary. The incumbent performs a… more
- Molina Healthcare (Racine, WI)
- …of care across the continuum, and contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties + ... services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term… 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...materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of… more
- Molina Healthcare (Racine, WI)
- …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more