- UpvoteDownvoteShare Job
- Suggest Revision
The Quality Liaison provides day to day support to the MVP Provider teams (Provider Engagement, Relations, Network and Contracting), works directly with Providers, Network and Community Based Organizations (CBO), to improve measures and performance for Medicaid and Medicare.
$56,200ExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
- Suggest Revision
Provider Relations or Provider Network Contracting experience, or. An understanding of at least one CMS healthcare quality program (HEDIS, ASCQR, CPC+, ESRD QIP, Home Health Quality Reporting Program, HHVBP, Hospice Quality Reporting, HACRP, IQR, OQR, HRRP, VBP, CMMI Models, IPFQR, IRF, LTCHQR, Medicaid-related programs, Medicare Advantage Quality Improvement Program, Medicare Parts C & D, Medicare Shared Savings Program, Nursing Home Quality Initiative, PACE, PCHQR, Quality Improvement Organizations, QPP, SNFQR, SNF VBP.
ExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Provide the same level of timely and accurate service to internal customers that rely on the work performed by Provider Relations. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs.
ExpandUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
7+ years of provider relations or contracting experience in a managed care or insurance environment, preferably in Medicare or Medicaid. Ensure timely Provider set up processing, auditing and distribution of Provider Relations data management.
ExpandUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
2-3 years' experience in provider relations and/or member services in managed care. Possess strong critical thinking skills and knowledge of Medicare and Medicaid regulations. Prior experience with Medicaid managed care.
$41ExpandUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Actively promote the CCM program in assigned facilities by partnering with key stakeholders (i e : internal sales function, provider relations, facility leader) to maintain and develop membership growth.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Provider Relations/contracting: To provide reports for the purpose of evaluating and advising UPMC HP management on the financial impact of proposed provider agreements or changes to existing agreements on an as-needed basis.
RemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Manager of Provider Relations will serve as the point person for managing the day-to-day relationship between MetroPlusHealth and top level administrators at each assigned network facility and community providers.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
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.
Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Regional Vice President will also provide executive leadership to the Provider Contracting, Provider Education and Provider Engagement in support of Humana's Commercial, Medicare, and Medicaid lines of business.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The end goal is for the provider to sign a Provider Services Agreement to participate in our client's Quality Program. Once a target provider signs a Provider Service Agreement (PSA), develop a plan to facilitate a warm handoff to the Client's Quality Team.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Familiar with the SC Medicaid Program and its services for persons with disabilities and special needs. Executive Director, Aldersgate Special Needs Ministry Aldersgate Special Needs Ministry (ASNM) is a private residential provider for adults with developmental disabilities.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Director coordinates with all functional areas of shared services partners, including but not limited to clinical operations, quality management, network development and management, provider relations, member outreach, education and member services, contract compliance and operations including claims and reporting.
Full-timeRemoteExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Experience in other provider related healthcare departments such as credentialing, provider relations or contracting preferred. Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.
Full-timeExpandUpdated 17 days ago - UpvoteDownvoteShare Job
- Suggest Revision
This role ensures that the Actuarial Department provides excellent services to various internal and external clients in the areas of pricing, reserving, forecasting, benefits, and product development, provider relations/contracting, underwriting, and compliance.
RemoteExpandApply NowActive JobUpdated 5 days ago
provider relations medicaid jobs
FEATURED BLOG POSTS
Tips to Get Your First Job Confidently
Whether you’re a recent graduate or you still have a few exams left, you may be itching to put your polished leather shoes on and join the workforce. After all, your first job is an entryway into the professional life you’d lead for the decades to come.
Tips for a Good Character Reference Letter with Examples
Hiring managers love a resume laden with relevant skills and qualifications. Hard skills specific to the role, like SEO strategy or Java programming languages, are easy to qualify using achievements or facts and figures. But how exactly can they verify personality traits, work ethic, relationship management skills, or curious nature during an interview when they barely know you?
How to Dress on the First Day of Work (Men & Women)
You did it! Out of hundreds of applicants and dozens of people interviewed, you’re the one who got a new job. Congrats! Now comes the question of how to dress on the first day of work.
Why College Students Should Work While in College?
College is a special part of our lives. It’s a time when we prepare for our dream job while creating some of the most memorable moments in life. That said, college life can also be stressful. Not only do we have to spend long hours studying, writing and researching, but we also have to deal with increased tuition fees and living expenses.
5 Ways to Measure Candidate Experience
Your candidate experience is made up of 4 essential parts
How to Stall a Job Offer Politely
You did it! After several weeks of looking for a new job and undergoing grueling interviews, you finally have a job offer. Although this may be very exciting, accepting a job offer means that you’re making a long-term commitment to your future employer. So, even if you’re eager to leave your current job, this isn’t a decision you should take lightly.
How to Get a Job in a New City - Best Tips to Follow
When your dream job posts, will you be ready? What if that dream job was in a faraway city or a different continent…would you move for it? Most of us have dreamed about what it would be like to accept a job in a new place at one time or another. But when it comes to actually making a move, it’s usually the logistical details that give us pause. The key to job searching in a different location is to have a plan.