- AmeriHealth Caritas (Washington, DC)
- …SW, Suite 1000, 10th Floor, Washington, DC 20024 **Responsibilities:** The Managed Care Provider Network Resolution Analyst is responsible for configuration ... providers in our network .; The Managed Care Provider Network Resolution Analyst ensures...+ One to two (1 - 2) years of Medicaid experience preferred. + Three (3) years in the… more
- Elevance Health (Las Vegas, NV)
- …actions to ensure compliance. + Participates in operational support of provider organization partners; ensure members, network providers, and community ... Vegas.** **HOURS** **: General business hours, Monday through Friday.** The Medicaid Contract/Implementation Management Manager ( Medicaid Contr/Implmnt Mgmt Mgr)… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …states/programs. Communicate to manager for key findings and changes to state programs. + Provide backup for Medicaid team members in any necessary functions and ... Medicaid Claims Analyst Date: Apr 16, 2025 Location:...terms. This position also provides assistance in resolving dispute resolution , weekly pay run activities, SOX audits, system upgrade/implementation… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …states/programs. Communicate to manager for key findings and changes to state programs. + Provide backup for Medicaid team members in any necessary functions and ... Medicaid Claims Analyst Date: Mar 21, 2025 Location:...terms. This position also provides assistance in resolving dispute resolution , weekly pay run activities, SOX audits, system upgrade/implementation… more
- Trinity Health (Ann Arbor, MI)
- …**Responsibilities** + Recruit providers to build a cost effective and high quality provider network within MediGold guidelines. + Serve as the MediGold point ... in MediGold's Ohio market, including: contracting and recruitment, issue resolution and escalations, strategy development and execution, education, and...of contact within the Provider network ; Act as the MediGold Subject… more
- CVS Health (Lansing, MI)
- …Assists with the design, development, management, and or implementation of strategic network configurations and integration activities. + Ensures resolution of ... + Healthcare Industry experience with either a payer or provider + Strong communication, critical thinking, problem resolution...system knowledge a plus. + Understanding of Medicare & Medicaid . + Proven working knowledge of provider … more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III Job Category: Provider Relations Department: Provider Network Management Location: Los Angeles, CA, US, 90017 ... public agency created by the state of California to provide health coverage to low-income Los Angeles County residents....net required to achieve that purpose. Job Summary The Provider Network Account Manager III is responsible… more
- Centene Corporation (Phoenix, AZ)
- …party for resolution + Receive and effectively respond to external provider related issues + Provide education on health plan's innovative contracting ... training, orientation and coaching for performance improvement within the network and assist with claim resolution . +...oversee testing and completion of change requests for the network + Investigate, resolve and communicate provider … more
- AmeriHealth Caritas (Asheville, NC)
- … provider issues. The position also involves monitoring and managing the provider network to ensure appropriate access to services, maintaining financial ... high-spend providers with multiple locations or specialties. + Monitor and manage the provider network to ensure compliance with state and federal mandates, as… more
- Centene Corporation (Olympia, WA)
- …and directories as well as claims payment resolution as it relates to provider set up. + Provide support to the external provider representative ... group, ancillary, etc.) are set up accurately in the provider information system for state reporting, claims payment, and...state deliverables, network reporting… more