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Provider Relations Remote Jobs

49 fresh jobs found

Senior Manager, Network Development
Remote

Healthcare Recruiting Insurance experience Outreach strategies Network development Technology Platform Provider Relations Network management Cost Management Value Propositions +24

Senior Full Time

USD 102K+

Claims Research & Resolution Lead
Remote US, United States

Long Term Services and Supports Trending Claims research Provider education Functional strategies Managed Care Contracts Claims resolution Driver safety program Microsoft Office Applications +66

Senior Mid Full Time

USD 94K+

Manager, Provider Data Operations Implementation
Dayton WFH, United States

Healthcare data operations Claims data management Provider data management Workflow improvement Healthcare Management Provider Relations Contract administration Resolution Healthcare administration +29

Senior Mid Full Time

USD 81K+

Pharmacy Coordinator
Remote-IN, United States

Centene Corporation

Formulary process Prior authorizations Grievances Employee Training Pharmacy Technician Provider Relations Utilization Health Plan Utilization Review +21

USD 64K+

National Dental Leasing Network and Provider Account Management Professional
Remote US, United States

Multi-Priority Management Provider education Provider Contracting Microsoft Office Applications Analyzing Provider Relations Trend Analysis Collaborative BI +34

USD 65K+

Provider Network Specialist II
Dayton WFH, United States

QuickBase Provider network Provider Relations Certification Contracting Network Auditing Recruitment Critical thinking +15

USD 61K+

Administrator, Pharmacy Reimbursement
United States

Navitus Health Solutions, LLC

Electronic funds transfer Network auditing Network Pricing Pharmacy reimbursement Ncrx Claims Adjudication Provider Relations Health Pharmacy +13

Senior Mid Full Time

USD 47K+

Network Operations Coordinator
Remote US, United States

Provider audits Data integrity management Contract Interpretation Processes Provider Relations Consumer Experiences Oversight Credentialing Interviewing +47

USD 53K+

Contract Negotiator II
Remote-NC, United States

Centene Corporation

Provider experience Contract Analysis Contract Compliance Guidelines Claims Adjudication Adjudication Provider Relations Health Plan Healthcare administration +22

USD 55K+

Patient Care Advocate
Remote-AR, United States

Centene Corporation

Member advocacy Quality Initiatives Provider experience Health coaching Health administration Telephonic Outreach NCQA HEDIS Provider Relations +35

USD 52K+

Provider Network Recruiter (Network Development)
Remote

Healthcare client management Outreach strategies Provider experience Quality of care Network development Healthcare Consulting Provider Relations Technology Platform Network management +20

USD 84K+

Provider Data Management Analyst I
Remote-MO, United States

Centene Corporation

Provider data management Healthcare operations Claims payment Provider Relations Credentialing Claims processing Claims Contracting Managed Care +18

Entry Full Time

USD 64K+

Provider Account Manager
Remote-TX, United States

Centene Corporation

Claims billing practices Claims billing Billing practices Provider Relations Commercial Insurance Health Plan Tracking Client Services Claims +24

USD 55K+

Network Performance Advisor
Remote-FL, United States

Centene Corporation

Risk contracting Utilization metrics Value-based contracting Network transformation Network performance Quality Metrics Network development Cross-functional Communication HEDIS +28

USD 55K+

Provider Relations Rep
Austin, Texas, United States

Texas Mutual Insurance Company

Network development Provider Relations Credentialing Contract management Customer service Marketing Data analysis Training

Entry Mid Full Time

USD 72K+

Contract Negotiator II
Remote-CA, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Claims Adjudication Contract Compliance Adjudication Provider Relations Healthcare administration Health Plan +21

USD 52K+

Contract Negotiator III
Remote-CA, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Claims Adjudication Contract Compliance Adjudication Provider Relations Healthcare administration Health Plan +20

Senior Mid Full Time

USD 68K+

Senior Vice President, Network Development & Contracting
Remote-IL, United States

Centene Corporation

Contracting management Provider contracts Network strategy Contract Analysis Provider Contracting Network development Network Operations Contract negotiations Provider Relations +29

Exec Senior Full Time

USD 221K+

Claims Research Specialist
Remote-MO, United States

Centene Corporation

Medicaid benefits Claims billing Claims research Government programs Claims payment Provider Relations Payment Processing Health Plan Referrals +15

USD 77K+

Contract Negotiator I
Remote-MO, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Contract Compliance Claims Adjudication Adjudication Provider Relations Healthcare administration Health Plan +20

Entry Mid Full Time

USD 55K+

Senior Director, Network Contracting & Services
Remote

Network Contracting Network performance Healthcare Strategy Contracting Strategies Provider Contracting Cost Containment Network development Healthcare Delivery Models +28

Senior Full Time

USD 192K+

Behavioral Health Prior Authorization Manager
REMOTE OPTIONS, PHOENIX

State of Arizona

Medicaid programs Program Planning Health care services Report development Policies and procedures Review Equal Opportunity Provider Relations Eligibility verification +51

USD 83K+

Team Assistant
Remote-NY, United States

Centene Corporation

Clerical duties Provider Relations Audits Administrative Support Data Entry Health Insurance Flexibility Access Benefits +6

Entry Full Time

USD 64K+

Contract Negotiator I
Remote-IA, United States

Centene Corporation

Healthcare Programs Guidelines Provider experience Contract Analysis Contract Compliance Claims Adjudication Adjudication Provider Relations Healthcare administration +20

Entry Mid Full Time

USD 55K+

Senior Manager, Provider Data Operations Implementation
Dayton WFH, United States

Claims data management Provider data management Healthcare Regulations Contract administration Provider Relations Healthcare administration Credentialing Azure DevOps Certification +42

Senior Full Time

USD 92K+

Program Manager (Provider Engagement)
Remote-OH, United States

Centene Corporation

Clinical improvements Managed healthcare Value-based contracting Health care operations Provider engagement Risk Adjustment Provider Relations Utilization Health Plan +31

USD 86K+

Senior Market and Operations Manager
Remote-MO, United States

Centene Corporation

Provider experience Community relations Operational reporting Problem identification Operational performance Utilization Provider Relations Healthcare administration Financial Performance +38

Senior Full Time

USD 105K+

Network Operations Coordinator
Remote US, United States

Data integrity management Medical claims Contract Interpretation Provider Relations Microsoft Teams Audits Claims BI Data integrity +42

USD 53K+

Provider Enrollment Coord II
Mississippi WFH, United States

URAC Phone Etiquette Critical Listening NCQA Provider Relations Accreditation Credentialing Certification Medical terminology +23

Entry Full Time

USD 36K+

Virtual Health Contracting Advisor
Remote US, United States

Key Performance Indicator Development Payment Model Design Medicaid Experience Contract Language Development Network development Model Development Provider Relations Healthcare administration RFP +50

USD 115K+

Provider Relations Representative - Evernorth Health Services - Remote, TX
TX, Houston, 2800 North Loop West, United States

The Cigna Group

Medical insurance knowledge Cigna Decision quality VLOOKUP Provider Relations Market intelligence Health Services Customer focus Consultative +18

USD 65K+

Dental Provider Contract Recruiter, DentaQuest
DQ Milwaukee WI, United States

Technology Promotion Office Equipment Provider Relations Credentialing Problem Resolution Contract Negotiation Market Research Diversity Stakeholder engagement +20

USD 74K+

Senior Provider Contracting Professional
Work at Home - Florida, United States

Provider Contracting Analyzing Network management Provider Relations Risk Negotiating Contracting BI Problem Resolution +32

Senior Mid Full Time

USD 78K+

Quality Practice Advisor
Remote-OK, United States

Centene Corporation

Risk Adjustment Coding Cphq Documentation standards Medical record documentation Provider education ICD-9 NCQA HEDIS Risk Adjustment +23

USD 52K+

Credentialing Assistant 3
HGB SCA Remote KY, United States

Tricare Intermediate mathematical ICD-10 codes Microsoft Office Applications ICD Provider Relations Mathematical Credentialing ICD-10 +36

USD 43K+

Provider Engagement Account Manager
Remote-OK, United States

Centene Corporation

Cost and utilization Network performance Quality measures Utilization Provider education Provider engagement HEDIS Provider Relations Health Plan +28

USD 55K+

Sr. Stars Improvement Professional
Remote US, United States

Provider performance Stars performance Team Engagement Clinical Management STARS Data Sharing Collaborative relationships HEDIS Provider engagement +63

Senior Mid Full Time

USD 86K+

Manager, National Ancillary Strategy and Contracting
Dayton WFH, United States

Provider Relations Resolution Contracting Conflict Resolution Managed Care Contract Negotiation Influencing Business Analysis Performance Management +26

USD 92K+

Director of PBM Network Contracting
United States

Navitus Health Solutions, LLC

Discount optimization Clinical performance assessment Medicare part d Pharmacy benefit management Network management Provider Relations Pricing strategy Client Services Health +12

Exec Senior Full Time

USD 120K+

Provider Engagement Account Manager (BH Exp)
Remote-MS, United States

Centene Corporation

Cost and utilization Network performance Quality measures Provider education Provider engagement HEDIS Health Plan Provider Relations Issue Resolution +26

USD 55K+

Fayetteville Lead Center Specialist
Full Time Remote - North Carolina, United States

Improvement Provider Relations Creative Problem Solving Community Engagement Medicare Customer Engagement Market Analysis Critical thinking Relationship building +12

Senior Full Time

USD 46K+

Staff Vice President, Value-Based Contracting Network Strategy & Development
Remote-MO, United States

Centene Corporation

Provider performance analysis Provider contracts Value-based contracting Network strategy Provider network development Provider Contracting Contract negotiations Network development Community Health +23

Exec Senior Full Time

USD 182K+

Contracts Manager
Remote-AR, United States

Centene Corporation

Cost and utilization Contract Development Provider Contracting Operational performance Healthcare Delivery Health Plan Provider Relations Healthcare administration Procedures +18

USD 86K+

Quality Practice Advisor
Remote-IL, United States

Centene Corporation

Clinical Relationship Management Cphq Documentation standards Risk Adjustment Coding Medical record documentation NCQA Provider education Health Plan HEDIS +23

USD 52K+

VP, PHCO Utilization Management Medicaid & Marketplace
Remote-MO, United States

Centene Corporation

Ncqa standards NCQA Clinical Training Financial Forecasting Provider Relations Acute care Marketplace Reconciliation Utilization Review +25

Exec Senior Full Time

USD 182K+

Senior Provider Relations Manager
Remote NV Las Vegas 89101, United States

Magellan Health Remote-first

Network compliance Health Plan Operations Client education Network management Provider Relations Training Programs Stakeholder Collaboration Presentations Outreach +8

Senior Full Time

USD 70K+

Credentialing Specialist
Working Virtually, United States

MultiCare Health System

Healthcare contracting Report generation Provider Relations Independent Judgment Credentialing Judgment Quality improvement Contracting Database Management +10

USD 57K+

Asst. Director Risk Adjustment Analytics
Portland, OR, United States

Cambia Health Solutions

Lean process improvement Analytical Modeling Health care systems DO Risk Adjustment Provider Relations Requirements Gathering Mathematics Lean +11

Exec Senior Full Time

USD 124K+

Provider Educator - Risk Adjustment
Portland, OR, United States

Cambia Health Solutions

HCC coding Health Care Industry Knowledge Dental Terminology ICD-10 Coding Reimbursement methodologies Provider education Risk Adjustment Provider Relations Medical terminology +9

USD 78K+

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