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The Alliance
Fitchburg, WI, United States
Summary: The Provider Contract Strategy Analyst III is primarily responsible for supporting contracting efforts of the Provider Contracting and Relations department by conducting reimbursement analyses and developing and preparing rate proposals. The position provides support to both internal and external customers related to understanding complex
Job Source: The AllianceWis Phys Svc Ins Corp
Madison, WI, United States
Director, Network Development and Provider Solutions WPS Health Solutions is a leading not-for-profit health insurer and federal government contractor headquartered in Wisconsin. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and provide customer suppo
Job Source: Wis Phys Svc Ins CorpAgrace HospiceCare
Madison, WI, United States
Job Details Job Location Madison - Madison, WI Position Type Full Time Travel Percentage Non-Driving Job Shift AM Job Category Finance Description Agrace is a nonprofit, community health care organization that is nationally recognized as a leader in the hospice industry. Well known for end-of-life care, Agrace also serves people across south
Job Source: Agrace HospiceCareCadmus
Madison
**Overview** **_What You’ll Be Doing_** Cadmus has an opportunity for a Contracts Manager to join our Contracts Department that has the desire and knowledge to make a positive difference at Cadmus. In this leadership role, the ideal candidate will be a strategic and tactical thought leader on a portfolio of diverse programs, mostly comprised of con
Job Source: CadmusHumana
Madison, WI, United States
Become a part of our caring community and help us put health first The Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Advi
Job Source: HumanaHumana
Madison
**Become a part of our caring community and help us put health first** The Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The Market Development A
Job Source: HumanaRing & DuChateau, LLP | Consulting Engineers
Madison, WI, United States
Ring & DuChateaus Commissioning department has an exciting opportunity for a talented and experienced Commissioning Provider in our Madison, WI office. Join our growing Commissioning Department and work closely with the Commissioning Department Co-Leads by developing, implementing, and coordinating quality assurance-based commissioning processes to
Job Source: Ring & DuChateau, LLP | Consulting EngineersPSG Global Solutions
Madison, WI, United States
Description We're looking for a Senior Contracts Manager , working in Pharmaceuticals and Medical Products industry in 5 Giralda Farms, Madison, New Jersey, 07940, United States . Job Description: Manages Clinical Trial Agreement (CTA). Ensures contracts are executed within fair market standards as appropriate. Answers questions and reso
Job Source: PSG Global Solutions, WI, United States
Job Description:
A health insurance company is seeking a Provider Contracting Director. The Provider Contracting Director will beresponsible forimplementing front-end contracting with providers and health systems, includingthe execution, negotiation and management of contracts. Thisis a relationship-based role that will have a high degree of visibility with providers in the marketplace. The director will deliver on the organization’s network and product expansion initiatives from a contracting perspective, including assessment of health systemand provider partners, as well as membership utilization trends to garner the most favorable and compliant provider network structures. This is a retained search.
Responsibilities:
Conduct an annual effectiveness review of contracting strategies.
Ensure compliance with all contracting regulations and requirements.
Oversee provider recruitment and implementation of contracts.
Hold responsibility for contracts and testing, initiating setup, overseeing post-configuration testing, and maintaining and auditing the configuration within the claims system.
Establish and maintain contract templates with contract language.
Administer provider contracts, terms and reimbursement rates in a manner that complies with company policies and regulations.
Requirements:
5+ years of provider contract negotiation experience in the health insurance industry
5+ years of process leadership experience
Managed care experience (preferred)
Bachelor’s degree in a healthcare-related field or equivalent work experience; master’s degree or equivalent work experience (preferred)
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Email Alert for Provider Contracting Director jobs in , WI, United States
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