- The Cigna Group (Birmingham, AL)
- …the Tri-South Alabama/Mississippi Market. Must live in either Alabama or Mississippi._** The ** Manager , Provider Contract Network Management** serves as ... reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. +...loading and submissions and interface with matrix partners for network implementation and maintenance. + May provide … more
- Pharmacy Data Management, Inc. (OH)
- At PDMI, we're seeking a talented Pharmacy Network Contract Manager to join our team! In this role, you'll play a crucial part in managing our pharmacy ... + Maintaining a deep understanding of pharmacy provider services and network demographics + Managing the implementation of contract language and… more
- CVS Health (Tallahassee, FL)
- …personal, convenient and affordable. Position Summary Join Aetna/CVS Health as the Manager of Contract Negotiation. In this high impact, individual contributor ... dispute resolution and settlement negotiations with providers and ensures contract performance aligns with accessibility, compliance, quality, financial, and cost… more
- Pharmacy Data Management, Inc. (OH)
- …ensuring alignment with PDMI's values and policies. Collaborating closely with our Pharmacy Network Senior Contract Manager and internal stakeholders, you'll ... cross-functional teams to address contract -related issues + Provide assistance with network credentialing and enrollment...publish policies and procedures for pharmacy provider network contracting + Stay updated on contract … more
- Elevance Health (Columbus, GA)
- The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and ... servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with less-complex to complex providers. Providers may include,… more
- Medical Mutual of Ohio (West Chester, OH)
- …as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** Provider Contract Manager I Under direct supervision, develops ... and external projects. . Performs other duties as assigned. Provider Contract Manager II Under...the provider network and national network offerings through contracting activities, contract negotiations… 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 ... education, and communication. This position is also responsible for all provider network recruiting and contracting management activities. + Ensures… more
- St. Luke's University Health Network (Allentown, PA)
- …Collaborate with Network department leaders and strategic vendor partners on contract negotiations to provide additional value such as rebates, equipment, ... ability to pay for health care. The Supply Chain Contract Manager will oversee the contracting portfolio...contracting portfolio of supplies, services, and equipment for the Network . Responsible for maintaining accurate contract data… more
- Commonwealth Care Alliance (Boston, MA)
- …Us:** Reporting to the Sr Director, **Quality Performance and Value Based Care,** the Provider and Facility Quality & Safety Manager is responsible for designing ... into other CCA contracts, health equity, and social determinants of health (SDOH) measures.The Manager of Provider and Facility Quality and Safety to improve the… more
- Elevance Health (Atlanta, GA)
- The Provider Network Manager Sr develops the provider network through contract negotiations, relationship development, and servicing. Primary ... link between professional providers and the company. + Ensure that network composition includes an appropriate distribution of provider specialties.… more
- Medical Mutual of Ohio (Dublin, OH)
- …resolves and/or refers issues regarding credentialing, claims, or other to the appropriate Provider Contract Manager or internal department; performs data ... the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million...issues regarding credentialing, claims, or other to the appropriate Provider Contract Manager or internal… more
- BlueCross BlueShield of Tennessee (Knoxville, TN)
- …educational topics, methods, and strategies to enhance compliance throughout the provider network \. + Implementing, supporting, and monitoring provider ... or equivalent work experience required _Experience_ + 3 years \- Experience in provider relations and network development with emphasis on healthcare education… more
- CVS Health (Sacramento, CA)
- …a team to manage relationships with our most key health systems and improve the provider experience for the network . Position will lead a team of Provider ... convenient and affordable. Position SummaryOversee and d esign, develop, contract , maintain and enhance relationships with facilities, physicians and ancillary… more
- Elevance Health (West Des Moines, IA)
- …Hybrid role (1-2 days per week in office) **Position Overview:** Develops the provider network through contract negotiations (language and rates), ... You Will Make an Impact:** + Contracting and negotiating contract terms + Typically works with less-complex to complex...providers in areas with increased competition or where greater provider education around managed care concepts is required +… more
- Elevance Health (Jacksonville, FL)
- …Specifically, Bay, Calhoun, Franklin, Liberty, Gulf and Jackson counties. **Develops the provider network through contract negotiations (language and rates), ... PRIMARY DUTIES: + Primary focus of this role is contracting and negotiating contract terms. + Typically works with less-complex to complex providers. + Providers may… more
- The Cigna Group (Anaheim, CA)
- …Excel, PowerPoint, Outlook) + Proficient in contract building software such as Contract Manager If you will be working at home occasionally or permanently, ... Travel out to in-person meetings with Providers._** The **AVP, Network Management** serves as an integral member of the...projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms. +… more
- The Cigna Group (Independence, OH)
- …utilizing HCPM/PRDS data, Activity Manager and/or Oracle Review tools to validate provider contract status + Work with Network Contracting to identify ... supports Cigna's presale and renewal process and is responsible for providing provider network reporting which assists potential customers in the decision-making… more
- Point32Health (Canton, MA)
- …responsible for the financial, regulatory, and legal terms negotiated with the provider network . The Senior Contract Manager must be able to develop ... performance, financial and otherwise, of the provider network . The Senior Contract manager ...train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented… more
- Molina Healthcare (Grand Rapids, MI)
- …Director in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of individual ... Michigan _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for... provider groups. * 3+ years experience in provider contract negotiations in a managed healthcare… more
- MyFlorida (Tampa, FL)
- …under their auspices; * Contract Management staff provide contract management including payment and reconciliation of provider invoices, completion of ... CONTRACT MANAGER SUPERVISOR - 60071273 Date:...program staff to ensure compliance with performance measures; * Contract Management staff identify any provider performance… more