Provider Contracting Manager jobs in Hawaii

Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Senior Strategic Contracting Manager
  • HMSA
  • Honolulu, HI FULL_TIME
    1. Design, develop and operationalize new clinical integration programs for key partners in market. Will act as primary program lead for value-based deals and special provider projects.
    2. Design, develop and operationalize next-generation payment models for key partners in market. Will collaborative build next-gen models with key ACOs leaders / PO leaders and high-value physicians in market.
    3. Act as chief negotiator, contract manager and relationship manager for all value-based partnerships in market. Will be lead for ensuring that program goals / terms are aligned with contract constructs.
    4. Act as the primary relationship manager for key partners in market and provide on-going BAU support to key provider partners. Sr Strategic Contracting Manager will
      • Be the primary business lead for all BAU processes associated with VB programs.
      • Lead provider meetings
      • Lead the process to build clinical pathways with provider partners.
      • Lead payment integrity & attribution integrity processes for all VB programs.
      • Lead design and operations for BAU/ad-hoc/executive reporting for all VB programs.
      • Ensure that all of the above will be coordinated with targeted provider partners.
    5. Act as internal program manager for all value-based projects. Sr. Strategic Contrating Manager will
      • Lead matrixed staff compliment -- comprised but not limited to program office (medicare/medQuest), legal, clinical operations, analytics-IT, finance staff.
      • Ensure that all internal divisions are apprised on status of all VB programs.
      • Lead all internal meetings with matrixed team members.
    6. Perform all other miscellaneous responsibilities and duties as assigned or directed.
    #LI-Hybrid

     

  • 13 Days Ago

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Network Contracting Manager
  • AlohaCare
  • Honolulu, HI FULL_TIME
  • Apply on line at http://www.alohacare.org/Careers/Default.aspx The Company: AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehe...
  • 22 Days Ago

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RN Unit Manager : Long Term Care SNF
  • Provider Management - Professional Search
  • , HI FULL_TIME
  • We are helping a Multi Level / Long Term Care facility in Hawaii find an RN Unit Manager. Excellent pay and benefits with an established provider of excellent hospital care for the right person. If yo...
  • 1 Day Ago

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Contracting Estimator
  • Sen Plex Corporation
  • Honolulu, HI FULL_TIME
  • SEN PLEX CORPORATION OAHU AIR CONDITIONING SERVICE, INC.OAHU PLUMBING & SHEET METAL, LTD. JOB DESCRIPTION POSITION Estimator CLASSIFICATION Full Time, Salaried COMPANY OPSM FLSA STATUS Exempt DEPARTME...
  • 21 Days Ago

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Contracting Clerk
  • Marisco, Ltd.
  • Kapolei, HI FULL_TIME
  • EXEMPT__________________________________ No SHIFT___________________________________ Day LOCATION________________ Campbell Industrial WAGE LEVEL__________Commensurate with experience DEPARTMENT_______...
  • 23 Days Ago

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Manager, Provider Operations - Provider Call Center Liaison
  • HMSA
  • Honolulu, HI FULL_TIME
  • Direct and oversee all aspects of the Provider Call Center, in alignment with corporate goals and initiatives. Manages, oversees, and evaluates staff. Ensure Provider Call Center performance meets/exc...
  • 1 Month Ago

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Provider Contracting Manager
  • Health New England
  • SUMMARY: The Provider Contracting Manager is responsible for leading or assisting with network development activities of...
  • 4/18/2024 12:00:00 AM

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Provider Contract Management Specialist
  • Cambia Health Solutions Inc
  • Portland, OR
  • Provider Contract Management Specialist Remote opportunity for residents of OR, WA, ID and UT Primary Job Purpose The Pr...
  • 4/18/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Chicago, IL
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/17/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Phoenix, AZ
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/17/2024 12:00:00 AM

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Provider Contract Management Specialist
  • Cambia Health Solutions, Inc
  • Portland, OR
  • Provider Contract Management Specialist Remote opportunity for residents of OR, WA, ID and UT Primary Job Purpose The Pr...
  • 4/17/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Kansas City, MO
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/17/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • San Francisco, TX
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/17/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Houston, TX
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/17/2024 12:00:00 AM

Hawaii (/həˈwaɪi/ (listen) hə-WY-ee; Hawaiian: Hawaiʻi [həˈvɐjʔi]) is the 50th and most recent state to have joined the United States, having received statehood on August 21, 1959. Hawaii is the only U.S. state located in Oceania, the only U.S. state located outside North America, and the only one composed entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean. The state encompasses nearly the entire volcanic Hawaiian archipelago, which comprises hundreds of islands spread over 1,500 miles (2,400 km). At the southea...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Manager jobs
$114,089 to $151,511

Provider Contracting Manager in Gastonia, NC
By simplifying and automating the provider contracting lifecycle, we help make it easier for health plans to identify and implement savings opportunities to obtain maximum value from provider relationships.
January 09, 2020
Provider Contracting Manager in Springfield, IL
Responsible for the oversight of their assigned networks to ensure network provider deficiencies are being met and working closely with their assigned Network Support staff and Medical Management counterparts to ensure network needs/changes are being effectively addressed and communicated both internally and externally.
January 19, 2020
Provider Contracting Manager in Cedar Rapids, IA
New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process.
February 03, 2020