With strong support for licensing and credentialing, we ensure our providers are equipped to serve patients in underserved areas. ...
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...
With strong support for licensing and credentialing, we ensure our providers are equipped to serve patients in underserved areas. ...
Designs, develops, and implements complex data models and enterprise software solutions that support provider data. Leads projects focused on the development of data models, application products and services delivery from end-to-end and has broad knowledge and awareness of evolving technical and bus...
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...
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...
The ideal candidate will bring extensive healthcare industry experience with a proven track record of delivering innovative clinical and strategic performance solutions to physician practices and provider systems. This individual will lead the design, development and implementation of solutions to c...
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...
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. ...
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 Director of Provider Recruitment is responsible for leading and managing the provider recruitment team to ensure the successful acquisition of providers. Provides guidance to provider recruiting staff on provider compensation. This role requires strategic planning, efficient execution of recruit...
Lead an organization responsible for implementing and managing a Provider Partnership Model that represents the Operations organization across Centene, defining an integrated provider operations strategy, corresponding roadmaps and initiatives delivery in support of that integrated strategy, and par...
Job Title: Virtual Primary Care Advanced Practice Provider- Licensed in LA,GA,IL,FL,TN, OH, PA, IN and/or TX (Remote/Part-Time). First Stop Health is in search of part-time advanced practice providers. Our primary care providers will treat patients virtually, via phone or video call,serving their ep...
Acts as a liaison between Tier II providers (large PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Serve as primary contact for providers and act as a liaison between the providers and the health plan. Perform provider orientations and ongoing provide...
Product Manager, Provider Workflows, you will partner directly with our clinical teams to improve the clinical quality and efficiency of our clinical workflows. ...
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...
We’ve built technology that helps people find great therapists with the first software-enabled national network of providers accepting insurance. US have a treatable mental health condition, but the majority of providers don’t accept insurance, making therapy too expensive for most people. Headway w...
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...
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 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...
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...
Collects, analyzes, and interpret market data in order to build and maintain compensation models for physicians and providers that meet business needs as well as recruit and retain provider talent with minimal oversight. Oversees the collection and submission of market survey data for all providers ...
Sandata is uniquely positioned as a software technology vendor serving both Payers and Providers in this growing segment of the healthcare market. The company is experiencing significant growth and is now looking for a Regional VP, Provider Sales to support that growth. In this role you will be resp...