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Elevance Health
Rocky Hill, CT, United States
Location: NH-Manchester, MA-Boston, MA-Woburn, MA-Newton, CT-Rocky Hill Job Description Summary: Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may incl
Job Source: Elevance HealthCVS Health
Hartford, CT, United States
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 center — our purpose sends a personal message that h
Job Source: CVS HealthOracle
Hartford, CT, United States
Job Description OCI's Network Capacity Planning team is hiring a Senior Manager to lead and drive the effort of this team. This team uses reports, dashboards, forecasts, and models to monitor and run OCI's global Cloud network capacity. The team uses data available to kick off a network augment via our augment process. This team monitors all layer
Job Source: OracleOracle
Hartford, CT, United States
Job Description As a Network Development Engineer on the Oracle Infrastructure Engineering Services (IES), Network Operations & Reliability Engineering team, your priorities include completing change requests, fulfilling service requests, incident response, and problem management. This role is also responsible for creating tools that facilitate ch
Job Source: OracleOxenham Group
, CT, United States
Senior Network Infrastructure Engineers provides engineering services and level 3 support associated with network, firewall, and telephone infrastructure both on-premises and in the cloud. Responsible for building, deploying, documenting, and maintaining functional, optimized, and secure network and telecom environments. Designs, configures,
Job Source: Oxenham GroupBlue Cross Blue Shield of North Dakota
, CT, United States
Senior Provider Network Performance Analyst You likely know us as an insurance company, but that’s just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It’s a mission we take seriously. We also work with entities throughout the state to challenge the
Job Source: Blue Cross Blue Shield of North DakotaOracle
Hartford, CT, United States
Job Description Candidates must be a U.S. Citizen and complete an enhanced background screening to meet federal government requirements. Organizational Overview Oracle Cloud continues innovative breakthroughs providing Autonomous Database and cloud services to an ever-increasing customer base. Oracle’s Infrastructure Engineering Services (IES) C
Job Source: OracleCVS Health
Hartford
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 center — our purpose sends a personal message that h
Job Source: CVS Health, CT, United States
Location: NH-Manchester, MA-Boston, MA-Woburn, MA-Newton, CT-Rocky Hill Job Description Summary: Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized. How you will make an impact:
Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
Works independently and requires high level of judgment and discretion.
May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
May collaborate with sales team in making presentations to employer groups.
Serves as a communication link between professional providers and the company.
Ensure that network composition includes an appropriate distribution of provider specialties.
Conducts more complex negotiations and drafts documents.
Prepare financial projections and conduct analysis.
Minimum Requirements:
Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Experience in fee schedule development using actuarial models strongly preferred.
Travels to worksite and other locations as necessary.
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Email Alert for Provider Network Manager Sr jobs in , CT, United States
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