Healthcare Provider Network Manager Jobs

... management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment ... coverage and services Collaborate with provider relations personnel to ensure high-quality ... care delivered through the BH..

Job Information Humana Manager, Behavioral Provider Contracting - Remote in Cincinnati ... in Cincinnati Ohio Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment ... and recruiting..

Description The Director, Provider Reimbursement is responsible for the ... and execution of Humana Military's provider reimbursement methodologies. This leader is ... prospective payment system software, and provider-specific reimbursement factors..

Job Description Are you seeking a career with purpose and growth? We have an exciting opportunity for a Pharmacist to join our CarePlus Specialty Pharmacy located in West Chester, OH. Specialty ..

... experience by increasing focus on healthcare services.OperationsResponsible for assisting pharmacist in ... of a pharmacist assists with healthcare service offerings including administering vaccines, ... the direction of the Pharmacy..

Description The Provider Contracting Professional 2 initiates, negotiates, ... initiates, negotiates, and executes dental provider contracts and agreements for an ... that provides health insurance. The Provider Contracting Professional 2..

... improvement throughout health plan operations, provider network and community partnerships to achieve ... by the National Association for Healthcare Quality (NAHQ), Certified QI Associate ... Quality Improvement/Quality Assurance in..

Description The Care Manager, Telephonic Nurse Assistant 2 receives ... from members. The NAL Care Manager, Telephonic Nurse Assistant 2 is ... is able guide members to in-network providers, answer..

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 ..

Job Information Humana Network Operations Lead - Behavioral Health/Medicaid ... in Cincinnati Ohio Description The Network Operations Lead maintains provider relations to support customer service ... integrity management and gathering..

... improvement throughout health plan operations, provider network and community partnerships to achieve ... by the National Association for Healthcare Quality (NAHQ), Certified QI Associate ... Quality Improvement/Quality Assurance in..

Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Cincinnati Ohio Description Humana is seeking an experienced management professional to lead an interactive multidisciplinary team that helps translate the clinical ..

... Tools, Education and Process for Network Language Resource Group is responsible ... for analyzing and improving current provider contracting templates, processes and standardization. ... provide internal support to all..

Description The Provider Contracting Coordinator 3 initiates, negotiates, ... negotiates, and executes behavioral health provider contracts and agreements for an ... provides health insurance. Responsibilities The Provider Contracting Coordinator 3..

Job Information Humana Director Medicaid Provider Services (State of OH) in ... Ohio Description The Director Medicaid Provider Services oversees the plan's strategic ... Services oversees the plan's strategic provider..

Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, ... executes physician, hospital, and/or other provider behavioral health contracts for an ... Medicaid segment. Responsibilities The Director, Provider Contracting- Behavioral..

Description The Care Manager, Telephonic Nurse Assistant 2 receives ... from members. The NAL Care Manager, Telephonic Nurse Assistant 2 is ... is able guide members to in-network providers, answer..

Job Information Humana Associate Director, Provider Relations (Ohio Medicaid) - Remote, ... is seeking an Associate Director, Provider Relations who will oversee the ... oversee the Ohio Medicaid plan's provider..

Job Information Humana Manager of Fraud and Abuse Data ... Cincinnati Ohio Description Responsibilities The Manager of Fraud and Abuse Data ... related efforts with Claims Oversight, Provider Network Operations,..

... Information Humana Director, Behavioral Health Network & Market Strategy (Medicaid) in ... The Director, Behavioral Health (BH) Network and Market Strategy will insure ... with business development teams and..

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

Job Information Humana Provider Contracting Professional 2 - Behavioral ... in Cincinnati Ohio Description The Provider Contracting Professional 2 initiates, negotiates, ... hospital, and/or other Behavioral Health provider contracts and..

Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, ... executes physician, hospital, and/or other provider behavioral health contracts for an ... or segment. Responsibilities The Director, Provider Contracting- Behavioral..