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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, and two urgent care offices.
$15.3 - $25.65 an hourExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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A strong understanding of non- Risk Adjustment functions such as Actuarial, Care Management, Accounting, Provider Contracting, Network Management, Product Development, etc., and how they impact Health Plan operations and financials.
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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.
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Post-acute care experience a plus, but not requiredLeadership background a plus, but not required; training will be providedActive and unrestricted Delaware licenseActive and unrestricted Delaware DEA Benefits:Full-time clinicians are eligible for an excellent comprehensive benefits package to include 401(k) plan, health, dental and vision insurance, long and short term disability, FSA, group term life insurance, Flex Time bank, and employee assistance program.
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This role involves collaboration with internal departments, legal team, and regulatory stakeholders to uphold the highest standards of compliance within the health plan provider network applicable to Washington state (OIC, HCA, CMS.
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Works with MHSU Embedded Care Manager, LP in participating in other high risk multidisciplinary complex case staffing as needed to include Vaya CMO/ Deputy CMO, Utilization Management, Provider Network, and Care Management leadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system.
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General Summary: Unum is looking for a Provider Data Analyst who will analyze, research, coordinate, and generate reports on provider and network data to support sales requests. Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not.
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Work closely with health plan leadership, the Chief Medical Officer, other Medical Leadership, Pharmacy Director, clinical staff (including those in utilization management, care management, quality management), and colleagues within network and provider relations, to enhance the delivery of holistic and integrated care.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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For more information on the provider network and pharmacies, see the The vision plan is offered through EyeMed Vision Care. For more information, see the Three dental plans are offered through Delta Dental (Delta Care, Delta Dental PPO, and Delta Dental PPO Plus) 1-800-237-6060.
$36,169 - $45,105 a yearExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Has overall responsibility for the content, maintenance and access to the Health Plan provider quality and practice transformation SharePoint site. Establishes the strategy and operational direction for provider engagement and practice transformation, in collaboration with the Plan President, network and operations staff for larger value based contracted provider organizations.
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SSM Health is an integrated delivery network with our own health plan located in Madison, enhancing coordination of care between provider & payor. SSM Health is a faith-based, non-profit organization focused on community, stewardship, respect, compassion, & excellence in care.
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Conemaugh Health System, of Duke LifePoint Healthcare, is the largest healthcare provider in west central Pennsylvania, serving over a half-million patients each year through the Conemaugh Physician Group and Medical Staff, a network of hospitals, specialty clinics and patient focused programs.
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Assisting members with authorizations, assist with the coordination of health care services between the Plan, network providers (all), RBM, Specialty Pharmacy, DME, and tertiary care facilities such as UCLA and other centers of excellence to ensure continuity of care for member.
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Ensures health plan provider engagement stakeholders are engaged and prepared to report quarterly updates at the meetings and overall, to health plan Senior Leadership Team meetings.
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Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
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