26 provider relations advocate jobs found

Care Transitions Nurse, Full time/REMOTE (Evergreen Park) Job ID: R65355 Shift: 1st Full/Part Time: Full_time Location: 9730 S Western Ave Evergreen Park, IL 60805 Benefits Eligible: Yes Hours Per Week: 40 Full Time Care Transitions Nurse 100% REMOTE POSITION, some evening and weekend coverage. Must have current Illinois license High-speed internet required Care Transitions role for 30 day program Medicare/ACO patient population/Medicare FFS program post-hospital discharge. Performs telephonic utilization management and associated discharge planning/authorization for AAH delegated risk and ACO members, to ensure appropriate level of care, excellent clinical outcomes, and to optimize the appropriate use of resources in the most cost-effective setting. Major Responsibilities: Responsible for performing telephonic utilization management for network and non-network hospital admissions. Ensures appropriate admissions are...

**Remote, work from home - East, TX (must live in/or near area)****Summary**The Provider Performance Advisor is a key member of a cross-functional, collaborative organization which includes Market Provider Performance, Sales, Stars & Risk Adjustment, Finance, Marketing, Provider Relations, and Network Development & Solutions. Reporting to the Provider Performance Senior Manager, the Provider Performance Advisor ensures the effective performance outcomes of their assigned providers.The Provider Performance Advisor's responsibilities include:+ Cultivating key provider partner relationships in order to drive optimal performance on Stars, risk adjustment, utilization management, and overall financial performance.+ Leading market level projects and strategies related to provider engagement.+ Preparing for and facilitating external provider meetings and value based contract administrative meetings (JOCs).+ Preparing for and facilitating a monthly financial review to senior...

Remote, work from home - Dallas/Ft. Worth, TX (must live in/or near area)SummaryThe Provider Performance Advisor is a key member of a cross-functional, collaborative organization which includes Market Provider Performance, Sales, Stars & Risk Adjustment, Finance, Marketing, Provider Relations, and Network Development & Solutions. Reporting to the Provider Performance Senior Manager, the Provider Performance Advisor ensures the effective performance outcomes of their assigned providers.The Provider Performance Advisor's responsibilities include:* Cultivating key provider partner relationships in order to drive optimal performance on Stars, risk adjustment, utilization management, and overall financial performance.* Leading market level projects and strategies related to provider engagement.* Preparing for and facilitating external provider meetings and value based contract administrative meetings (JOCs).* Preparing for and facilitating a monthly financial review to senior...

At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) The TN C&S Health Plan Provider Relations represents government products to build and improve physician, facility and practice satisfaction for the TN C&S Health Plan. This is an internal and external focused position and is responsible for the market and will maximize the providers ability to interact with the Health Plan as applicable. If you are located within the Brentwood, TN area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Acts as a TN C&S Health Plan navigational specialist for internal and external business...

At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) The TN C&S Health Plan Provider Relations represents government products to build and improve physician, facility and practice satisfaction for the TN C&S Health Plan. This is an internal and external focused position and is responsible for the market and will maximize the providers ability to interact with the Health Plan as applicable. If you are located within the Brentwood, TN area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Acts as a TN C&S Health Plan navigational specialist for internal and external business...

At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) The TN C&S Health Plan Provider Relations represents government products to build and improve physician, facility and practice satisfaction for the TN C&S Health Plan. This is an internal and external focused position and is responsible for the market and will maximize the providers ability to interact with the Health Plan as applicable. If you are located within the Brentwood, TN area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Acts as a TN C&S Health Plan navigational specialist for internal and external business...

At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) The TN C&S Health Plan Provider Relations represents government products to build and improve physician, facility and practice satisfaction for the TN C&S Health Plan. This is an internal and external focused position and is responsible for the market and will maximize the providers ability to interact with the Health Plan as applicable. If you are located within the Brentwood, TN area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Acts as a TN C&S Health Plan navigational specialist for internal and external business...

**The GEA Way** At GE Appliances, a Haier company, we come together to make "good things, for life." As the fastest-growing appliance company in the U.S., we're powered by creators, thinkers and makers who believe that anything is possible and that there's always a better way. We believe in the power of our people and in giving them the freedom to explore, discover and build good things, together. The GEA Way philosophy, backed by three simple commitments defines the way we work, invent, create, do business, and serve our communities: _we come together_ , _we always look for a better way_ , and _we create possibilities_ . Interested in joining us on our journey? Since 1990, Advanced Services Inc. (ASI) has been providing excellent customer service to GE Appliances consumers by resolving their questions or concerns about GE Appliances. During that time, we have developed a culture of celebrating and rewarding our employees! We are leaders in positioning talent for exciting...

At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm) The TN C&S Health Plan Provider Relations represents government products to build and improve physician, facility and practice satisfaction for the TN C&S Health Plan. This is an internal and external focused position and is responsible for the market and will maximize the providers ability to interact with the Health Plan as applicable. If you are located within the Brentwood, TN area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Acts as a TN C&S Health Plan navigational specialist for internal and external business...

Strategic Marketing Senior Advisor, Middle Market, Select and Broker - Work at Home Job Description We are currently seeking an insights-driven, results-obsessed Strategic Marketing Senior Advisor responsible for leading the creation and development of comprehensive multi-channel marketing strategies that align with enterprise goals and fuels growth for Cigna's Middle Market and Select businesses as well as our Producer and Broker teams. Using a modern marketing approach, the candidate will leverage their B2B and D2C experience and analysis of forward-looking market trends and data-driven insights to position these businesses for success. The portfolio of work will require engagement with diverse external audiences including brokers, employer prospects, clients and customers. The candidate will be accountable for planning marketing programs that: drive new business (B2B and B2B2C; acquire and promote customer enrollment; enhance client satisfaction; differentiate Cigna in...

**Remote, work from home - East, TX (must live in/or near area)****Summary**The Provider Performance Advisor is a key member of a cross-functional, collaborative organization which includes Market Provider Performance, Sales, Stars & Risk Adjustment, Finance, Marketing, Provider Relations, and Network Development & Solutions. Reporting to the Provider Performance Senior Manager, the Provider Performance Advisor ensures the effective performance outcomes of their assigned providers.The Provider Performance Advisor's responsibilities include:+ Cultivating key provider partner relationships in order to drive optimal performance on Stars, risk adjustment, utilization management, and overall financial performance.+ Leading market level projects and strategies related to provider engagement.+ Preparing for and facilitating external provider meetings and value based contract administrative meetings (JOCs).+ Preparing for and facilitating a monthly financial review to senior...

**Remote, work from home - New Jersey (must reside in/or near area)****Summary**The Provider Performance Advisor is a key member of a cross-functional, collaborative organization (which includes Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment, Finance, Marketing, Cross-Segment Contracting, Provider Relations, and Network Development & Solutions). Reporting to the Provider Performance Manager/Senior Manager/Operations Director/Operations Senior Director (Market President), the Provider Performance Advisor ensures the effective performance outcomes of their assigned providers.The Provider Performance Advisor's responsibilities include:+ Cultivating key provider partner relationships in order to drive optimal performance on Stars, risk adjustment, utilization management, and overall financial performance.+ Leading market level projects and strategies related to provider engagement.+ Preparing for and facilitating external provider...

**Remote, work from home - Dallas/Ft. Worth, TX (must live in/or near area)****Summary**The Provider Performance Advisor is a key member of a cross-functional, collaborative organization which includes Market Provider Performance, Sales, Stars & Risk Adjustment, Finance, Marketing, Provider Relations, and Network Development & Solutions. Reporting to the Provider Performance Senior Manager, the Provider Performance Advisor ensures the effective performance outcomes of their assigned providers.The Provider Performance Advisor's responsibilities include:+ Cultivating key provider partner relationships in order to drive optimal performance on Stars, risk adjustment, utilization management, and overall financial performance.+ Leading market level projects and strategies related to provider engagement.+ Preparing for and facilitating external provider meetings and value based contract administrative meetings (JOCs).+ Preparing for and facilitating a monthly financial review to...

**Remote, work from home - Dallas/Ft. Worth, TX (must live in/or near area)****Summary**The Provider Performance Advisor is a key member of a cross-functional, collaborative organization which includes Market Provider Performance, Sales, Stars & Risk Adjustment, Finance, Marketing, Provider Relations, and Network Development & Solutions. Reporting to the Provider Performance Senior Manager, the Provider Performance Advisor ensures the effective performance outcomes of their assigned providers.The Provider Performance Advisor's responsibilities include:+ Cultivating key provider partner relationships in order to drive optimal performance on Stars, risk adjustment, utilization management, and overall financial performance.+ Leading market level projects and strategies related to provider engagement.+ Preparing for and facilitating external provider meetings and value based contract administrative meetings (JOCs).+ Preparing for and facilitating a monthly financial review to...

Parkland Community Health Plan’s (PCHP’s) Senior Complaint and Appeals Analyst is responsible for intake, investigation, distribution, and resolution of complaints and appeals for Medicaid including STAR, CHIP, and CHIP Perinate. Cooperates with multiple business units to obtain all information needed to assure final resolution and response. Ensures timely, customer focused acknowledgment of all complaints and appeals. Identifies and reports trends and emerging issues and recommends solutions.   Minimum Specifications   Hybrid/Remote must reside in TX    Education Bachelor’s degree.   Experience Five years of experience in Medicaid/CHIP/CHIP Perinate products and benefits. Three years of experience in medical claims systems, medical management, managed care organization compliance and regulatory requirements. Experience in provider relations, customer service and audit experience are preferred. Experience in research and analysis of claim processing is preferred....

Remote 8-5 PST Want to be part of an amazing team, hell-bent on crafting a better future? We're always looking for creative people who care! We are consultants. Strategists. Creators. Doers. Achievers. Explorers. Geeks. Hipsters. Leaders. Learners. Renegades. Seekers. Visionaries. And we fundamentally believe that we're better together. We're looking for a Customer Advocacy Program Lead to support the Global Customer Advocacy Program (GCAP) within the Microsoft Cloud Marketing organization to drive impact with one of our leading client teams. This world-class, highly visible team supports several Microsoft teams including sales, marketing, analyst relations, and events. This team is on a mission to grow the number of advocates who are excited to share their experience leveraging Microsoft's leading solutions (Azure, Microsoft Dynamics 365, Modern Work, Microsoft 365, Power Platform among others) to accelerate innovation and drive business results. This CA Lead serves as a...

Who We Are BankUnited (NYSE: BKU) is a national bank headquartered in Miami Lakes, Florida with banking centers in Florida, the New York metropolitan area, Dallas and Atlanta. BankUnited has two subsidiaries, Pinnacle Public Finance headquartered in Scottsdale, Arizona and Bridge Funding Group headquartered in Hunt Valley, Maryland. We pride ourselves on our entrepreneurial and collaborative culture encompassing the best minds, the brightest talent and the boldest decision makers. BankUnited is ranked #4 as one of America's Most Trusted Companies in the Banking industry and is honored to have been included on the Newsweek and Statista America's Most Trusted Companies Award List! Our Culture At BankUnited, we foster a diverse and inclusive environment where all employees have the opportunity to advance, grow and achieve their goals. Our rally cry is to GO FOR MORE , a call to action to go above and beyond to provide the best customer experience to every client and to GO FOR...

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an environment of excellence and the highest ethical standards - a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities. Everything we do at Allstate is driven by a shared purpose: to protect people from life's uncertainties so they can realize their hopes and dreams. For more than 89 years we've thrived by staying a step ahead of whatever's coming next - to give customers peace of mind no...

AHIP is looking for an experienced Regional Director to advance AHIP's legislative and regulatory agenda in assigned states (Arizona, California, Hawaii, Nevada, Oregon, Utah & Washington) and lead State Affairs' engagements in broader responsibilities as assigned. If you are looking to make a real difference through your career journey, why not do it with the foremost health insurance advocacy organization in the nation? AHIP is the industry-leading trade association of health insurance providers striving to make health care better and coverage more affordable for every American. Our team works among the nation's most influential policymakers and stakeholders with front-row seats to make an unparalleled impact and change with policy advocates, leading conveners and conferences, foremost innovators, and champions of the healthcare industry. Position Summary: The Regional Director is responsible for developing relationships with state agencies by anticipating government...

Become a Part of the NIKE, Inc. Team NIKE, Inc. does more than outfit the world's best athletes. It is a place to explore potential, obliterate boundaries and push out the edges of what can be. The company looks for people who can grow, think, dream and create. Its culture thrives by embracing diversity and rewarding imagination. The brand seeks achievers, leaders and visionaries. At NIKE, Inc. it's about each person bringing skills and passion to a challenging and constantly evolving game. NIKE is a technology company. From our flagship website and five-star mobile apps to developing products, managing big data and providing leading edge engineering and systems support, our teams at NIKE Global Technology exist to revolutionize the future at the confluence of tech and sport. We invest and develop advances in technology and employ the most creative people in the world, and then give them the support to constantly innovate, iterate and serve consumers more directly and personally....