Acts as a liaison between Tier III and Tier IV providers (small to medium 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 orientati...
The Senior Manager, Sales Operations is responsible for overseeing and optimizing the sales operations of the Provider Engagement team, whose primary goal is contracting with medical providers to grow our provider network. Willingness to dive in and learn about health plans, provider contracting and...
Molina’s Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures maintenance of Provider Quality Improvement programs in accordance with prescribed quality standards; con...
Regional Sales Director position for Service Providers. ...
With over 500 nationwide providers, Skin Clique is at the forefront of reshaping the aesthetics industry, providing a unique opportunity for Advanced Practice Providers (Nurse Practitioners and Physician Assistants) to thrive in a flexible and fulfilling role. At Skin Clique, we prioritize the well-...
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 II providers (large PCP groups not on risk contrac...
Through ongoing coaching and skills development our Account Executives become consultants on PatientPoint products and are an integral part of the Provider Solutions team. Represent PatientPoint Provider Solutions in a positive and professional manner. Demonstrate knowledge of PatientPoint Provider ...
Work in partnership with SVP, Provider Experience and serve as a strategic clinical thought leader for the provider experience strategy aligned with the organization's mission, vision, and values. Work with provider experience, quality and population health teams to develop clinical outcome tools an...
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...
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. ...
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...
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...
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...
Our ability to have accurate and accessible provider data allows us to better serve our members and providers, reduces our administrative cost and burden, and informs our strategic business decisions and core operations. This role will be responsible for leading projects to support navigating member...
The ideal 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. He/she will work on the Guidehouse Commercial Healthcare Operational Effectiv...
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 a full-time mental health provider for Spring Health, you will focus on care delivery of Spring Health’s member network. You have been a 1099 Provider with Spring Health for at least 3 months. You like working independently but would also enjoy having the support of a team and opportunities for c...
This involves identifying potential providers, negotiating contracts, and maintaining strong relationships with existing providers. Leading contract negotiations with healthcare providers to ensure favorable terms for both the organization and the providers. Addressing and resolving any provider-rel...
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...
Job Title: Virtual Primary Care Advanced Practice Provider- Licensed in LA,GA,IL,FL,TN, OH, PA 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 episod...
With over 500 providers nationwide, Skin Clique is at the forefront of reshaping the aesthetics industry, providing a unique opportunity for Advanced Practice Providers (Nurse Practitioners and Physician Assistants) to thrive in a flexible and fulfilling role. At Skin Clique, we prioritize the well-...
Create the future of e-health together with us by becoming a Provider Enrollment Specialist. Compiles and maintains current and accurate data for all providers. Completes provider enrollment credentialing and re-credentialing applications; monitors applications and follows-up as needed. Maintains co...
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...