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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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SUMMARY: The Provider Contracting Manager is responsible for leading or assisting with network development activities of commercial and government programs including: preparing contract proposals in accordance with financial, operational and quality objectives, drafting and negotiating contract terms, contract implementation and maintenance.
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Evaluates, helps formulate, and implements the provider network strategic plans to achieve contracting targets and manage medical costs through effective provider contracting to meet state contract and product requirements.
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Position Title : Provider Relations Advocate Work Location : Remote/Telecommute Work Hours : 9 am – 5 pm Position Background : The Provider Relations Advocate plays a crucial role in recruiting and contracting network providers, as well as providing network support.
RemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Possessing working experience in Payer or Provider operations (domain areas such as Medical Management, Population Health Management, Utilization Management, Provider Network Management, Value-Based Contracting, Provider Relations, Quality Improvement, Informatics, ACO operations, etc.
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Collaborate regularly with internal departments, including but not limited to: Finance, Medicare Operations, Network Management, Provider Contracting, and Health Economics, and external vendors on risk adjustment projects.
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The individual will also assist the Director for Provider Contracting and Network Development to develop provider collaborations that ensure network growth and quality/efficiency targets.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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LOCATION: Supports the Franklin, TN market and will work in the Franklin, TN office several days per week Medicare Advantage position The Manager, Provider Network Contracting serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager.
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As an Advanced Practice Nurse (APN), the NP will demonstrate leadership as a mentor, educator, researcher and provider. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more.
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Work with the Director, Provider Relations staff, and other internal PHC departments to monitor access issues and identify various types of healthcare providers and facilities for contracting opportunities.
$72,067.77 - $93,687.81 a yearExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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The Manager, Provider Network Contracting serves as an integral member of the Provider Contracting Team and reports to the Provider Contracting Senior Manager.
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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.
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Minimum of 3 years relevant work experience in Network Management, Contracting or Provider Relations in a managed care setting, health plan or large medical group administration. The Provider Relations Network Manager is responsible for general management of the provider network as assigned by the Director of Network Management as well as for supporting the Network Management Department in meeting the overall network growth and development goals.
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We own an extensive network of pipeline transportation, terminalling, storage and gathering assets in key crude oil and NGL producing basins and transportation corridors and at major market hubs in the United States and Canada.
$50Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Provider Network Management Director. Minimum Qualifications:Requires a BA/BS degree and a minimum of 8 years’ experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
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