- Humana (Atlanta, GA)
- …and help us put health first** Humana Healthy Horizons is seeking a Provider Contracting Professional who initiates, negotiates, and executes physician, ... provider contracts and agreements related to Medicaid health plans. The Provider Contracting Professional work assignments are varied and frequently… more
- Elevance Health (Atlanta, GA)
- …Requires a BA/BS degree and a minimum of 5 years' experience in contracting , provider relations, provider servicing; experience should include prior ... development using actuarial models strongly preferred. + Experience with ancillary provider and/or dialysis facility contracting . + Value-based contracting… more
- CVS Health (Atlanta, GA)
- …Internal Aetna system knowledge a plus + Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, ... National Value Based Care (VBC) Development who will support innovative and strategic provider relationships as part of the VBC Business Development team. You will… more
- Humana (Atlanta, GA)
- …and operational problems within contracts, and leads multiple highly specialized professional associates. They will be directly responsible for the strategic ... to make an impact** **Required Qualifications** + 5+ years of experience in Contracting (build, language, or negotiation) + 3+ years of experience in value-based… more
- Humana (Atlanta, GA)
- …Qualifications** + 1 - 3 years of Health care or managed care with Provider Contracting , Network Management or Provider Relations experience + Proven ... caring community and help us put health first** The Provider Engagement Professional - Network Development and...providers is a key function of this role. + Provide support to Provider Offices on all… more
- Elevance Health (Atlanta, GA)
- …Care Consultant** provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving ... large scale initiatives with high dollar cost savings opportunities. Partners with provider contractors to develop contracting strategy and supports all aspects… more
- Elevance Health (Atlanta, GA)
- …with a particular focus on fraud, waste, and abuse, compliance and provider contracting arrangements/transactions. + Using professional legal theories ... knowledge of Medicare and Medicaid managed care and will provide strategic advice and recommendations to executives and management...our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors… more
- Elevance Health (Atlanta, GA)
- …Experiences:** + Healthcare experience strongly preferred. + Experience working with Provider network analytics strongly preferred. + Healthcare contracting and ... ** Provider Network Analyst Lead** **Location:** This position will...identify network adequacy gaps and access deficiencies and recommends contracting targeted providers to close gaps. + Participates in… more
- Elevance Health (Atlanta, GA)
- …(JOC) meetings. + Researches and analyzes issues that may impact future provider program participation. + May provide mentorship, training, guidance to ... Provider Relationship Account Manager Sr. (Value-Based Contracts) (JR142924)...complex, Value Based Program operating structures and diverse integration/risk contracting strategies. + Advocates for portfolio of assigned providers;… more
- CVS Health (Atlanta, GA)
- …commercial etc.). + Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission ... assigned providers and internal business partners to manage relationships and ensure provider needs are met. Ensures resolution of escalated issues related, but not… more