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Five (5) years of experience working with financial analysis supporting managed care contracting with providers including but not limited to hospitals, professionals ranging from large medical groups to solo practitioners, mental health practitioners, ASCs, skill nursing facilities, renal dialysis facilities, home health and DME. Current working knowledge of all aspects of a provider contract.
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Understanding and applying FACETS functionality to the ever-changing environment including consumer driven healthcare, and complex provider contracting requirements. Have broad understanding of health plan wide processes, including claims processing, medical/payment policies, product implementations, provider network development and contract management.
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Familiarity with the Regence health care provider community, contracting protocol and reimbursement methodologies desired. Works with the legal department, regulatory compliance teams, and Network Management contracting staff to file documents, as applicable, with the Insurance Commissioner/Department of Insurance for each state where the Health Plan contracts with providers.
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IES is a national provider of industrial products and infrastructure services to a variety of end markets, including electrical, mechanical and communications contracting solutions for the commercial, industrial, residential and renewable energy markets.
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Understand business rule logic for the functional area and high level business requirements for each product line, provider network etc. Ensuring all existing PHP provider and employer contracts and regulatory requirements are correctly and effectively administered.
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Provider Engagement Director would have a bachelor’s degree (Master's preferred) in Business Administration, Healthcare Administration or related field and 12 years relevant experience in a large healthcare delivery, health insurance or health care consulting organization with specific experience building provider partnerships and/or value-based agreements or equivalent combination of education and experience.
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The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.
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Best-in-class Support Center to handle all administrative tasks including but not limited to - client intake, recruiting, payroll, HR, billing, credentialing/contracting, and scheduling. As a CASP Provider, ALP will grant you access to CASP’s entire CEU library which includes over 75 CEU-approved courses (plus 10 CEUs annually via ALP events such as our IMPACT Conference and monthly live sessions.
Starting at $78,000 a yearFull-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Call Points: Acute Care, Biomed, Radiology, Cath Lab, VP of Imaging, Supply Chain, Contracting, Service Line Coordinators. Our client is a single source provider of medical, surgical, diagnostic imaging, and ultrasound equipment, including sales, service, repair, parts, refurbishing, and installation.
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Balfour Beatty US is an industry-leading provider of general contracting, at-risk construction management and design-build services for public and private sector clients across the nation.
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Assist with network development and provider contracting with various providers and ancillary providers. DescriptionHumana's Associate Vice President (AVP), Technology and Cybersecurity Risk works closely with all areas of Enterprise Information Protection (EIP), Internal Audit, Enterprise Risk Management, business units, regulator.
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Participate in Quality Operations including Quality Management Committee, monitor initial peer review on quality of care complaintsParticipate in National, Regional and local meetings of organizations of interest to Group MedicareSpeaking engagements to provide thought leadership on behalf of Humana Group MedicareOversee quality improvement and HEDIS/STARS metrics to improvement with corporate and local market resources.
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The Provider Customer Service Representative is the initial point of contact for the CareOregon Provider Network which includes contracted providers, non-contracted providers and those providers interested in contracting.
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We are a leading full-service provider of power infrastructure, construction and support services in utility and energy contracting throughout the Pacific Northwest and neighboring states.
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Description & Requirements Responsible for Maximus' MES Provider services strategy, and growth, as well as capability development and delivery. Oversee all aspects of the business unit to include the operational performance, strategic planning, contracting actions, subcontractor management, human resources assignments, recruiting, hiring, financial management, budgeting, and business development.
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provider contracting jobs in Portland, OR
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