- CVS Health (Richmond, VA)
- …affordable. Position SummaryIn this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high level review and rate ... and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the development and implementation… more
- Humana (Columbus, OH)
- …us put health first** Humana Healthy Horizons is a seeking a Senior Project Manager ( Medicaid Network Implementation) who is accountable for working with the ... with driving efficient management of end-to-end provider-related functions in new Medicaid market implementations. The Senior Project Manager makes decisions… more
- Sumitomo Pharma (Columbus, OH)
- **Title: Sr. Manager , Medicaid Contract Administration** **Location: Remote/occasional onsite (if local to MA). Flexible work/life balance.** Sumitomo Pharma ... a dynamic, highly motivated, and experienced individual for the position of **Sr. Manager , Medicaid Contract Administration.** The Sr. Manager , Medicaid… more
- University of Utah Health (Murray, UT)
- …our mission. EO/AA_ Under the direction of the Provider Network Director, the Manager of Provider Contracting is responsible for negotiation and renegotiation of ... with all departments and providers throughout the state. The Manager of Provider Contracting must be highly...+ Detail oriented. + Knowledge of and experience with Medicaid and Medicare insurance programs. + Knowledge of the… more
- CVS Health (Houston, TX)
- …Position Summary In this individual contributor role the Network Management Senior Manager will negotiate, execute, and conduct high level review and rate analysis, ... and ancillaries in accordance with company standards. As a Senior Network Manager you will manage contract performance and support the development and implementation… more
- CVS Health (Houston, TX)
- …be proficient in Word, Excel, and Microsoft Office. Preferred Qualifications + Medicaid contracting experience. + Strong critical thinking, problem resolution, ... health care more personal, convenient and affordable. In this Texas Medicaid individual contributor role the contract negotiator: + Negotiates competitive contracts… more
- Helsinn Therapeutics (US), Inc. (Iselin, NJ)
- …Benefits Manager (PBM) and exposure to Trade, Retail, Federal and Medicaid contracting . + Experience in dealing with current Pharmaceutical and Healthcare ... Senior Director Pricing, Contracting & Value Strategies Operations Iselin, New Jersey...to AMP, ASP, Best Price, URA calculations, 340B, HCR, Medicaid and Reimbursement. + CORE COMPETENCIES: + Project Management:… more
- Hartford HealthCare (Wethersfield, CT)
- …common practices across the system. *_Position Summary:_* Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst develops a modeling ... and protections to minimize payer policy impacts on hospital revenue to Manager of Payer Contract Analytics. 2. Develops modeling process to benchmark reimbursement… more
- WellSense (Manchester, NH)
- …network adequacy and performance including leading NH product expansion, recruitment and contracting efforts. The Contract Manager will lead contract language ... NH Contract Manager WellSense Health Plan is a nonprofit health...and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical… more
- AmeriHealth Caritas (Palm Beach Gardens, FL)
- ** Manager Provider Network Management** Location: Palm Beach Gardens, FL Primary Job Function: Medical Management ID**: 29175 Your career starts now. We're looking ... This position is also responsible for all provider network recruiting and contracting management activities. + Ensures that the department and staff remain current… more
- CVS Health (Austin, TX)
- …make health care more personal, convenient and affordable. Position Summary The Manager , Business Consultant is front facing to the vendor partners conducting ... to meet the state needs and achieve positive business results. The Manager , Business Consultant will foster strong, ongoing client relationships by transferring… more
- Cleveland Clinic (Cleveland, OH)
- …world. As part of the CCHS Value Based Performance team, the Program Manager will help support value based contracting , implementation, program management, and ... value based contracts and programs with commercial payors. The Value Based Performance Program Manager IV serves as a key member of Value Based Performance Team for… more
- CVS Health (Phoenix, AZ)
- …Experience in Value Based Care financial models and value based care contracting /negotiations. + Experience in Medicaid Risk-based arrangements and Value-Based ... convenient and affordable. Position Summary Aetna is recruiting for a Senior Manager , National Value Based Care (VBC) Development who will support innovative and… more
- CVS Health (Hartford, CT)
- …Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager . In this role, you will manage negotiations, conduct high-level reviews and ... contracts and value-based relationships. **Role is for national behavioral health contracting and strategic partnerships Key deliverables in this role include: *… more
- CVS Health (Lansing, MI)
- …(preferred), Ohio, Indiana, Kentucky or Illinois. 20% travel is required. The Manager , Business Consultant is front facing to the vendor partners conducting reviews ... to meet the state needs and achieve positive business results. The Manager , Business Consultant will foster strong, ongoing client relationships by transferring… more
- CommonSpirit Health (Englewood, CO)
- …KY. Strongly prefer someone located within the South Region. The Region Contract Manager for Payer Strategy & Relationships (PSR) assists PSR leaders in the ... development, implementation and management of PSR system standards for contracting and payer relations. Accountabilities include: ensuring that managed care… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …all rebate payments for completeness and accuracy managing revenue leakage. The manager will work collaboratively with Contracting Strategy and Account Directors ... based on new business needs. **A Typical Day Might Look Like This:** The Manager , Government Pricing (GP) and Contract Operations position is a key member of… more
- Molina Healthcare (Chicago, IL)
- …state _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with ... result in high quality, cost effective and marketable providers. Contract/Re- contracting with large scale entities involving custom reimbursement. Executes… more
- Commonwealth Care Alliance (Farmington Hills, MI)
- **Why This Role is Important to Us:** The Provider Contract Manager is responsible for developing, negotiating and managing contractual, legal and financial ... compliance requirements. - Maintain a solid understanding of Medicare and Medicaid reimbursement methodologies for assigned services. - Assure network adequacy for… more
- CVS Health (Oklahoma City, OK)
- …relationships by assisting with or responding to complex issues regarding Medicaid policies and procedures, plan design, contract language, service, claims or ... contract coordination- Performs credentialing support activities as needed- Educates Medicaid providers as needed to ensurecompliance with contract policies and… more