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Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work ..
Description The Provider Contracting Administration Professional 2 supports the administration of the contracting function. The Provider Contracting Administration Professional 2 work assignments are varied and frequently require interpretation and independent determination ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Job Information Humana Provider Contracting Executive - Hospital Systems in Tampa Florida Description The Provider Contracting Executive - Hospital Systems, initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
... quality and clinical compliance with contract requirements as outlined in the ... codes. Our Department of Defense Contract requires U.S. citizenship for this ... timely and in accordance with..
Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems ..
Description Job Description Summary The RVP Health Services relies on medical background to create and oversee clinical strategy for the state of Florida. The RVP Health Services requires an in-depth understanding ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description The Provider Contracting Administration Coordinator 2 supports the administration of the contracting function. The Provider Contracting Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
... Professional for SC Medicaid communicates contract terms, payment structures, and reimbursement ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting ... and communicating..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Description The Pharmaceutical Manufacturer Relations Executive ensures the Pharmacy trade strategy aligns with formularies and the desired health outcomes of patients. The Pharmaceutical Manufacturer Relations Executive works on problems of diverse ..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description The Senior Provider Contracting Professional - Hospital Systems initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Senior Contracting Professional - Hospital Systems work assignments involve ..
Description Assignment Capsule: Be a part of a team that's dedicated to improving the health and well-being of our members, our associates, and the communities we serve. This position offers an ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
