Located in the East Leader should be familiar with provider market trends, demonstrate deep healthcare provider domain experience and able to leverage technology and strategic consulting to deliver value and outcomes to clients. Should be familiar with providermarket trends and demonstrate deep heal...
As Hawaiis leading healthcare establishment, the statewide network has more than 8,000 employees and more than 1,500 affiliated physicians and providers. ...
The MRS Provider Support Line Representative is responsible for assisting providers with inquiries related to claims, contracts, authorizations, benefits, services, registries, and community resources. MRS Provider Support Line Representative are trained in specific functional areas for provider ser...
Under the direction of the Supervisor, Revenue Cycle Enrollment, the Provider Enrollment Coordinator will be responsible for the insurance carrier enrollment and re-enrollment of clinical staff and ancillary providers, the maintenance of these providers in the Medical Staff Office system and in CAQH...
The MRS Provider Support Line Representative is responsible for assisting providers with inquiries related to claims, contracts, authorizations, benefits, services, registries, and community resources. MRS Provider Support Line Representative are trained in specific functional areas for provider ser...
Provider must have a clear active Medical License. Provider must be Board Certified in specialty requested. ...
The Provider Network Analyst is responsible for providing technical support to Healthcare Analytics and the Provider Network Operations department by producing, analyzing, interpreting, and using reports needed for network analytics, monitoring of team and provider performance (volume and processing...
Make and oversee credentialing system updates ensuring provider contracted and credentialing status is properly reflected in the Provider Data Management tool, Provider360. Communicate delegation & credentialing status to providers and ensure proper updates are made to the provider management system...
Coordinates and prepares for external provider meetings and ensures that the most impactful internal subject matter experts (clinical, pharmacy, financial, analytical, etc. Medicaid Managed Care with a strong knowledge of Value Based Contracting and/or Provider Performance. ...
This role is responsible for setting the Specialty Pharmacy Provider (SPP) strategy for Pfizer’s products to drive optimal medication access and patient adherence. Responsibilities include working with the brand teams to develop patient support programs, in conjunction with Specialty Pharmacy Provid...
Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid Provider data within Aetna QNXT. Provider Operations, Provider Relations or Network operations. Team will also include provider operations analyst and pre-cred support for implementation activitie...
As a Healthcare Provider Directory Validation Assistant, you will play a crucial role in ensuring the accuracy and integrity of healthcare provider directories. When not involved in provider directory validation activities, the Healthcare Provider Directory Validation Assistant may be required to pr...
Understanding of Provider data including NPI/Tax ID/Provider Specialty/Demographic information. Works with Team and internal counterparts to ensure claims are processed quickly for our providers and Members. Must be able to manage constantly changing priorities, work independently and assess and eva...
Humana”) offers competitive benefits that support whole-person well-being.Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.Among our benefits, Humana provides medical, dental and...
Maintains critical Complex provider information on claims and provider databases. This role negotiates contracts with the Complex Provider Community that result in high quality, cost effective and marketable providers. In conjunction with Director, Provider Contracts, develops health plan-specific p...
CHC is one of the country’s most creative and dynamic providers of primary medical, dental and mental health services to the uninsured and underinsured. We are one of the leading health-care providers in the state of Connecticut, providing comprehensive primary care services in medicine, dentistry, ...
Incumbents are responsible for: 1) ensuring accurate and timely credentialing and subsequent submission of provider information to support claims submission, 2) ensuring submission of information that assures accurate and timely data for systematic provider demographics, 3) performing as the point o...
With our Mobile Health Network of professional and private transportation providers, we service a large community of members of select health plans using your own vehicle. We are seeking professional, punctual, polite, and responsible individuals to use their own vehicles to serve as independent Mob...
Working with the Director, Network & Provider Analytics and other members of the Network & Provider Analytics team, the Senior Manager will lead the analytic support of contract negotiations, strategic initiatives and regulatory requests. The Senior Manager will directly support complex analysis rel...
Maintains the provider file, the provider information inventory workflow system and electronic provider files with updated provider information during processes, such as credentialing, recredentialing, demographic updates, terminations, and all other provider file maintenance activities. This role w...
Serve as primary contact for providers and act as a liaison between the providers and the health plan. Perform provider orientations and ongoing provider education, including writing and updating orientation materials. Acts as a liaison between Tier III and Tier IV providers (small to medium PCP gro...
Provider Enrollment Specialist is a vital team member with Centauri’s Out of State Medicaid billing agency that works with facilities across the US to process their Out of State Medicaid claims with a focus on hospital billing, hospital and physician enrollment, and eligibility verifications. Resear...
Shared living providers develop strong, supportive, often roommate or family-like relationships with the individual in their home. With a reputation built on "going the distance," Spurwink has the experience and clinical expertise to help both providers and individuals experience success. Spurwink p...
Providence Health Plan is calling a Provider Data Specialist who will:. Be responsible for the management of provider contracts. Be a liaison between the provider, health plan and Ayin. Provide EDI support, data importing, EDI testing and provider customer service. ...
We're hiring an Associate to join our Provider Success team. The Associate, Provider Success drives solutions to acute and systemic issues within Oscar’s operations. The Associate owns end-to-end solutioning of provider escalations, orchestrating efforts cross-functionally with multiple internal par...