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Provider Relations Remote Jobs

48 fresh jobs found

Patient Care Advocate
Remote-AR, United States

Centene Corporation

Member advocacy Provider experience Quality Initiatives Health administration HEDIS NCQA CPT coding Health coaching Risk Adjustment +34

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+

Manager, Provider Relations
Remote-OK, United States

Centene Corporation

Health delivery systems Provider contracts Provider Contracting Staff management Provider Relations Health Plan Credentialing Quality Standards Supervisory +16

USD 86K+

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+

Provider Engagement Administrator II
Remote-NJ, United States

Centene Corporation

Claims reimbursement Claims billing Cost and utilization Network performance Utilization Provider education Provider engagement HEDIS Provider Relations +27

USD 55K+

Provider Account Manager II
Remote-TX, United States

Centene Corporation

Health Plan Operations Provider Contracting Data Systems Long Term Care Commercial Insurance Provider Relations Health Plan Performance Improvement Issue Resolution +27

USD 55K+

Sr. Nurse Reviewer - Provider Relations
Any city, MA, US, 99999

Gainwell Technologies

Interqual criteria Prepayment review Pre-admission screening Post payment review RN license InterQual Processes Provider Relations Clinical Review +30

Senior Full Time

USD 64K+

Enterprise Clinical Quality Analyst II
Dayton WFH, United States

Ncqa standards NCQA Provider Relations Microsoft Access Credentialing Healthcare Knowledge Performance Improvement CMS Clinical Experience +32

USD 61K+

Provider Engagement Account Executive
Remote-OK, United States

Centene Corporation

Value-based performance Utilization Cost and utilization Interpersonal relationships Quality measures HEDIS Health administration Provider engagement Network management +37

Exec Mid Full Time

USD 86K+

Provider Relations Manager
Remote

iCare Health Solutions

Optometry Provider Relations Credentialing Training Development Managed Care Medicare Medicaid Coaching Interpersonal +5

USD 96K+

Manager, Enterprise Network Contracting
Dayton WFH, United States

Provider networks Provider Relations Contracting Network Managed Care Business Analysis Performance Management Critical thinking Access +20

Senior Mid Full Time

USD 92K+

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+

Senior Director, Network Contracting & Services
Remote

Network Contracting Network performance Contracting Strategies Provider Contracting Healthcare Delivery Contract negotiations Technology Platform Cost Containment Models +26

Senior Full Time

USD 192K+

Team Assistant
Remote-NY, United States

Centene Corporation

Telephone Communication Provider Relations Audits Administrative Support Data Entry Health Insurance Flexibility Access Benefits +6

Entry Full Time

USD 64K+

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+

Claims Liaison I
Remote-TX, United States

Centene Corporation

Reimbursement interpretation Provider contracts Provider Billing Claims Adjudication Adjudication Provider Relations Information systems Claims processing Claims +12

USD 77K+

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+

Pharmacy Coordinator II
Remote-NV, United States

Centene Corporation

Formulary process Prior authorizations Grievances Managed care experience Health Plan Provider Relations Utilization Review Prior authorization Medical management +18

USD 77K+

Provider Account Manager
Remote-TX, United States

Centene Corporation

Claims billing practices Claims billing Billing practices Health Plan Commercial Insurance Provider Relations Client Services Contracting Service Delivery +23

USD 55K+

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+

Patient Care Advocate
Remote-ME, United States

Centene Corporation

Member advocacy Quality Initiatives Provider experience NCQA Health administration Telephonic Communication HEDIS Risk Adjustment Telephonic Outreach +35

USD 52K+

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+

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+

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+

Director of Education and Outreach (Must Reside in Nevada)
Remote NV Las Vegas 89108, United States

Magellan Health Remote-first

Tactical direction Loading Contract administration Network management Provider Relations Healthcare administration Cost Management Financial modeling Care management +12

Exec Senior Full Time

USD 105K+

Provider Engagement Professional
Work at Home - Florida, United States

Medicaid policies V-look ups Medicare policies Stars performance Data Sharing STARS Tables Reimbursement methodologies Provider Contracting +52

USD 25K+

Staff Vice President, Network Development & Hospital Contracting
Remote-FL, United States

Centene Corporation

Value-based contracting Provider communication Provider experience Provider education Provider engagement Network development Network management Health Systems Provider Relations +19

Senior Full Time

USD 182K+

Provider Contract Analyst
Full Time Remote - North Carolina, United States

Healthcare network management Strategic contracting Provider incentive programs Shared risk arrangements Provider reimbursement Contract administration Provider Relations Medicare Medicaid +12

USD 61K+

Quality Practice Advisor
Remote-IN, United States

Centene Corporation

Cphq Medical record documentation Risk Adjustment Coding Documentation standards NCQA Provider education ICD-9 Risk Adjustment HEDIS +19

USD 52K+

VP, PHCO Utilization Management - Medicare & Duals
Remote-FL, United States

Centene Corporation

NCQA Ncqa standards Clinical Training Financial Forecasting Provider Relations Acute care Utilization Review Medical management Training Programs +21

Exec Senior Full Time

USD 182K+

Manager, Contracting & Network Development
Remote-NC, United States

Centene Corporation

Provider Recruitment Contract Analysis Contract Compliance Health administration Network development Call center Operations Provider Relations Credentialing Contracting +15

USD 86K+

Accounts Receivable Specialist / Provider Relations Sr. Analyst - Remote
New Hampshire Work at Home, United States

The Cigna Group

Proclaim Task analysis Resource Utilization Claims Administration Claim processing VLOOKUP Provider Relations Customer Interaction Health Services +18

Senior Mid Full Time

USD 58K+

Accounts Receivable Manager - Provider Relations Lead Analyst - Remote
California Work at Home, United States

The Cigna Group

PMHS Proclaim Claims Administration Provider Contracting Facets Provider Relations Health Services Financial Contracting +22

Senior Mid Full Time

USD 65K+

Provider Relations Manager/Provider Relations Lead Analyst - CA - Remote
California Work at Home, United States

The Cigna Group

Medical insurance products OneView Health care knowledge Matrix collaboration HCPM Service Improvement Decision quality PC Software Provider Relations +22

Senior Mid Full Time

USD 65K+

Contract Negotiator II
Remote-NV, United States

Centene Corporation

Contract Analysis Provider Contracting Contract Compliance Claims Adjudication Provider Relations Healthcare administration Contracting Database Management Claims +18

USD 55K+

Network Operations Coordinator 3
Remote US, United States

Intermediate mathematical Rosters PAAG Administrative processes PMDM Provider Audits Data integrity management Tables Contract Interpretation +44

Entry Mid Full Time

USD 44K+

Pharmacy Coordinator II
Remote-WA, United States

Centene Corporation

Formulary process Grievances Prior authorizations Managed care experience Provider Relations Cost analysis Utilization Review Medical management Prior authorization +16

Entry Mid Full Time

USD 44K+

Provider Relations Specialist- REMOTE
Home, United States

Prime Therapeutics

Pharmacy benefit management Provider Relations Prior authorization Call Center Critical thinking Benefits PowerPoint Access Word +6

USD 59K+

Contract Negotiator
Remote-WA, United States

Centene Corporation

Claims Adjudication Provider Relations Healthcare administration Contract Compliance Credentialing Claims Contracting Network Business administration +10

USD 55K+

Senior Provider Education Professional (Medicaid)
Remote US, United States

Managed healthcare contracts Learning design principles Template design Health Plan Operations Microsoft Office Word Learning Design Matrixed environment Provider Relations Provider education +44

Senior Full Time

USD 78K+

Manager, Autism Clinical Care
Remote-LA, United States

Centene Corporation

Functional behavioral analysis Behavioral services Quality of care Medical Review Behavioral Analysis Accreditation Claims resolution Clinical Oversight Provider Relations +21

USD 86K+

VP, Network Development & Contracting
Remote-TX, United States

Centene Corporation

Network development Provider Relations Healthcare administration Market Expansion Due Diligence Contracting Network Business administration Health Insurance +18

USD 182K+

Senior National VBC Performance Manager
Remote-NY, United States

Centene Corporation

Bilingual Mandarin Network development Mandarin Provider Relations Bilingual (English Contracting Bilingual (Spanish) Contract management Health Insurance +12

Senior Full Time

USD 86K+

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