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Provider Relations Remote Jobs

35 fresh jobs found

Analyst, Pharmacy Contract Audit
United States

Navitus Health Solutions, LLC

Pricing structures Pharmacy contract auditing PC2 Ncrx Network Pricing Contract Interpretation Compliance monitoring Provider Relations Operational processes +15

Entry Mid Full Time

USD 52K+

Provider Data Management Analyst I
Remote-FL, United States

Centene Corporation

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

Entry Full Time

USD 38K+

Provider Engagement Professional 2
Work at Home - Florida, United States

Medicare policies Bonus methodologies Data Sharing Clinical Management Provider Contracting Reimbursement methodologies Analyzing Consumer Experiences Provider engagement +49

USD 59K+

Customer Care Rep
Remote USA, United States

Provider Relations Call Center Multi-tasking Data Entry Empathy Critical thinking Word Microsoft Office Attention to detail +5

Entry Mid Full Time

USD 32K+

Sr. Risk Adjustment Administration Professional
Remote US, United States

EMR interoperability Claims Submission Population health management Medical Director Assist Provider education Interoperability Provider Relations Population health +64

Senior Full Time

USD 78K+

Sr Manager, Provider Data Operations Implementation (Implementation experience a must)
Dayton WFH, United States

Provider data management Contract administration Provider Relations Healthcare Regulations Prior authorization Healthcare administration Project Planning Credentialing Enrollment +50

Senior Full Time

USD 92K+

Provider Engagement Account Manager
Remote-DE, United States

Centene Corporation

Consultative account management Demographic information changes Claims Submission Cost and utilization Quality measures Network performance Provider education Utilization Provider engagement +31

USD 55K+

Quality Practice Advisor
Remote-IL, United States

Centene Corporation

Performance Data Healthcare Standards Medical record documentation Cphq Risk Adjustment Coding Provider education HEDIS ICD-9 Guidelines +26

USD 52K+

Network Management Specialist - Remote
United States, United States

Magellan Health Remote-first

Provider Relations Network management Security Controls Contracting Presentations Evaluation Auditing Microsoft Office Suite Quality Assurance +8

Entry Mid Full Time

USD 45K+

Provider Services Materials and Communication Professional supporting DSNP
Work at Home - Virginia, United States

Template design Provider communications Learning design principles Learning Design Assist Health Plan Operations Matrixed environment Microsoft Office Applications Rating +49

USD 59K+

Provider Relations Consultant
Wisconsin

Network relations Healthcare Policies Provider Relations Credentialing Claims management Data Collection Contract Negotiation Excel

USD 65K+

Director of Territory Management
Remote, US

InStride Health

Healthcare business development Market growth strategy Provider Relations Analytics tools CRM Software Market Research Mentoring Business Development Coaching +4

Exec Senior Full Time

USD 140K+

Provider Quality Liaison
Remote-SC, United States

Centene Corporation

Consumer assessment HOS CAHPS Grievances Quality performance Member Experience Medical record documentation Quality Initiatives Pharmacy Technician +32

USD 64K+

Provider Engagement Professional
Work at Home - Florida, United States

HireVue Driver safety program Provider Contracting Data Sharing Clinical Management Analyzing Reimbursement methodologies Provider engagement HEDIS +50

USD 25K+

Behavioral Health Medical Director
Dayton WFH, United States

Clinical care standards Safe Prescribing Healthcare data analysis Systematic Thinking URAC Critical Listening Clinical Leadership NCQA Provider Relations +30

Exec Mid Full Time

USD 191K+

Field Services Specialist III
Remote, LA, United States

Complex instruction following Map reading Field Investigations Local Travel Provider Relations Self-Motivation Health care Microsoft Outlook HR +14

Senior Mid Full Time

USD 36K+

Provider Relations Specialist II - Bilingual Spanish
Remote-PR, United States

Centene Corporation

Managed care experience Provider Relations Financial Performance Health Plan Credentialing Project Coordination Financial Claims processing Contracting +16

USD 55K+

Benefits Management Analyst II
Remote USA, United States

Relational Database Programming Provider Relations Data Mining Oral communication Power BI PowerPoint Word SQL Attention to detail +5

Entry Mid Full Time

USD 69K+

Provider Engagement Administrator II
Remote-NJ, United States

Centene Corporation

Claims billing Claims reimbursement Cost and utilization Network performance Provider education Utilization Provider engagement HEDIS Provider Relations +29

USD 55K+

Provider Engagement Specialist III
Mississippi WFH, United States

Health analytics Provider network management Provider Recruitment Provider network Critical Listening Provider Contracting Provider engagement Engagement Strategies NCQA +44

Senior Mid Full Time

USD 63K+

Director, Provider Contract Operations & Support
Remote

Operational insight Provider Contracting Healthcare Strategy Network Operations Program Design Provider Relations Technology Platform Team Development Contracting +20

Exec Senior Full Time

USD 156K+

Provider Engagement Account Manager
Remote-WA, United States

Centene Corporation

Consultative account management Demographic information changes Cost and utilization Quality measures Network performance Provider education Provider engagement Utilization Provider Relations +30

USD 55K+

Provider Relations Advocate (Remote)
MINNEAPOLIS, MN, United States

ACD systems Medical insurance terminology Webchat Text messaging VoIP Systems Provider Relations Email Communication Microsoft Word Microsoft Excel +2

USD 48K+

Quality Practice Advisor
Remote-ME, United States

Centene Corporation

Healthcare Standards Medical record documentation Risk Adjustment Coding Cphq Provider education Documentation standards HEDIS NCQA ICD-9 +25

USD 52K+

Clinical Integration Liaison - Licensed/Remote in CA
Remote CA San Diego 92101, United States

Magellan Health Remote-first

Utilization Analysis Clinical Practice Guidelines Substance abuse Provider Relations Security Controls Discharge planning Community Resources Referrals Presentations +14

Exec Mid Full Time

USD 58K+

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+

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+

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+

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+

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+

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+

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+

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+

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+

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+

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