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The Manager, Provider Contract Network Management serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Director. 3+ years of Provider Contracting and Negotiating experience involving complex delivery systems and organizations requiredExperience with Physician, Hospital and Ancillary group contracting and negotiationsExperience with Healthcare - Commercial and Medicare AdvantageExperience in developing and managing key provider relationshipsKnowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Proficient in Network Management, Provider Contracting. The Senior Manager will be responsible for contracting and implementing fee for service and value based agreements with key physician groups, facilities and ancillary providers to support commercial and individual exchange networks.
$67,900 - $190,700 a yearFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Required Qualifications: 2+ years of provider relations and/or provider network experienceExperience with Medicare regulationsExperience in claims issue resolution at an intermediate level of proficiencyExperience utilizing MS Word, Excel, PowerPoint and Access at an intermediate level of proficiency Preferred Qualifications: Experience delivering exceptional presentations *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Supporting Commercial, MA, Medicaid, Medicare and Medicaid Dual Eligible provider contracting of ancillary and ancillary facility providers across all lines of business including preparation of Single Case Agreements.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Internal network liaison for Claims, Provider Services, Utilization Management, and other company departments as needed. Some Major Duties Include: Negotiate LOA and MOU for the IPA's managed by IMS. Negotiate provider agreements and amendments to include physicians and ancillary providers as needed.
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The organization includes three hospitals, four medical parks, Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. This individual also directs and guides patient care activities of ancillary personnel and other patient care personnel while maintaining standards of professional nursing practice.
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This experience will include thorough knowledge of contracting with physicians and physician groups, integrated delivery systems, health systems, and ancillary providers using various payment methodologies including fee-for-service and value based / risk.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
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As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health's network includes over 27,000 primary care providers, specialists and participating clinics.
$96,682 a yearFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Assist with network development and provider contracting with various providers and ancillary providers. Serve as clinical liaison and medical leader in meetings and conversations with inpatient facilities and provider joint operating committees to maintain facility relationship and participate in problem solving, including discussing contract language related to medical management/clinical services, as well as case review discussions.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Be well-versed on financial aspects of various levels of risk bearing contracts, and possess the ability to gain traction for provider adoption. Participate in regional or Humana national level committees, including meetings related to medical necessity determination processes and Medical Director audit processes.
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The Sr. Manager, Provider Contracting will report to the Director, PPO Professional, Specialty & Ancillary Networks. Your RoleThe Provider Partnerships & Network Management team is responsible for managing California’s largest PPO Physician Network to support our members in achieving access to high quality care at an affordable price.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Nuvance Health has a network of convenient hospital and outpatient locations - Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN) Performs discharge planning coordination/referral by making appropriate referrals to social services, ancillary departments, outpatient case management, DME, post-acute placement, and other outside agencies per Standard Operating Procedure (SOP.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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The Cigna Group Director, Provider Network Management - East TN market supporting Medicare Advantage Bloomfield , Connecticut Apply Now LOCATION: This is a HYBRID position aligned to the Tennessee market.
ExpandApply NowActive JobUpdated 11 days ago
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