Are you an Adult LCSW licensed in .SUD/Dual Diagnosis experience? We have an exciting opportunity for you to work 100% remotely! .Iris Telehealth is seeking compassionate LCSWs with .SUD or Dual Diagnoses experience.EST for a 100% remote outpatient opportunity.This position requires 40 hours per wee...
The Senior Provider Relations Consultant (Snr PRC) is responsible for managing an assigned territory of professional and facility behavioral health providers to enhance their relationships with WellSense Health Plan across Medicare, Medicaid and Commercial products. The Snr PRC serves as primary lia...
At this time, we are only looking for MD/DO candidates.Higher compensation and bonus for candidates with active California licenses.Iris Telehealth is seeking compassionate psychiatrists to work 24 to 40 Hours per week with an all-ages population.While working for a Joint Commission Accredited organ...
Bring your heart to CVS Health.Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health.This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world.Anchored in our brand — with heart at its cente...
Maintain collaborative relationships with physicians, hospitals, ancillary providers along with health plan and corporate teams. Act as the first line of contact for providers/hospitals on claims projects and other non-routine claim issues. Positively engage and collaborate with key stakeholders whi...
Provider-side experience in a health system, hospital strategy. Solid background in broad-based provider financial modeling 3+ yrs. Provider-side experience in a health system, hospital strategy. ...
Providers (Physicians, Physician Assistants and Nurse Practitioners) and Radiologic Technologists. ...
We are seeking a Channel Development Manager, Service Providers who can evangelize Intermedia’s unique value propositions for our solutions, including UCaaS, CCaaS and other business collaboration tools, and differentiate our service provider program in a compelling manner to prospective partner exe...
The Guidehouse Commercial Healthcare Payer/Provider candidate will have experience in the healthcare industry, preferably in performance improvement within Health Systems, Hospitals, Health Plans or Physician Groups. You will work on the Guidehouse Commercial Healthcare team driving margin and opera...
The PNR partners with Provider Relations in the provider contracting process; in researching provider inquiries; in identifying and creating Best Practices; and providing an overall seamless level of customer service to the provider network. This position maintains provider networks to overall persi...
Responsible for accurately completing the enrollment/re-enrollment processes of providers as identified through department policies, network reimbursement and delegated contracts to ensure timely and continued provider participation. Proactively initiates oversight of existing provider record issues...
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. Maintain partnerships between the health plan and the contracted provider network...
This CSM should possess acute domain knowledge as well as a strong understanding of how Provider Organizations, Hospital Systems, or Health plans operate to facilitate an optimal CSM-customer partnership. ...
Deep familiarity with health insurance data, including contract structure and methodologies, claims, eligibility, provider and benefit data. Strong understanding of Provider Contracting & contract negotiations. In-depth understanding of managed care business processes, data, systems, reimburseme...
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...
In order to maintain exceptional quality and member experience on our platform, the opportunity to work on the CirrusMD Provider Network team is limited to high performing providers who have proven the ability to manage patients effectively and efficiently, while earning high patient satisfaction sc...
The Provider Coding Educator is coordinates medial record coding audits, conducts provider training sessions on diagnosis coding and develop training guidelines, process and procedures for medical record coding in an effort to maximize reimbursement. Experience with delivering presentations, conduct...
Implement provider office education, where necessary, and provide formal training to providers and staff regarding coding and documentation standards. Conduct chart reviews for providers and review provider. Attend risk adjustment and quality provider meetings for assigned provider groups to provide...
As the product manager for the Provider Coding pod, your goal is to discover and develop a solution for one of the most pressing problems that providers are facing today: how to ensure that they get paid appropriately, and how to accomplish this in an environment of increasing costs and fewer people...
The Provider Enrollment Specialist is responsible for managing the payer enrollment and revalidation processes for clinicians within Netsmart's client network. This role ensures that all healthcare providers are properly enrolled with payers and that their credentials are kept current to maintain co...
Oversee the Senior Director of Provider Governance in the creation of processes and tools for market provider engagement teams to manage provider performance effectively. Oversee initiatives to streamline administration, reduce costs, and enhance provider satisfaction through direct collaboration wi...
Create the future of e-health together with us by becoming a Provider Enrollment Account Manager. Compiles and maintains current and accurate data for all providers. Complete Statewide credentialing/recredentialing applications to add providers to commercial payers, Medicare, and Medicaid. Track lic...
The Manager of Global Operations has an overall responsibility to ensure all required tasks are performed in a consistent, timely, and highly professional manner.The Manager of Global Operations ensures objectives, principals, values, mission and foundation are clearly stated.The position also ensur...
Curana’s Provider Network Management team is looking for an enthusiastic and motivated individual to fill the critical role of Provider Network Analyst. As an Analyst, you will play a vital role in building and maintaining a robust provider network and ensuring the accuracy of provider information. ...
Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems in support of claims adjudication and provider directory. Works with other departments to ensure quality provider data to our members. Conducts and m...