This role involves overseeing the strategic and operational management of a healthcare provider network. The role ensures network design, credentialing, enrollment, data management, and compliance meet regulatory and accreditation standards. The position emphasizes operational excellence, strategic oversight, and effective provider relationship management.
Healthcare operations leader with deep expertise in quality improvement across diverse provider networks. Responsible for overseeing the performance and reliability of the organization's network infrastructure. Leads cross-functional efforts that improve provider engagement, optimize workflows, and elevate overall network performance.
Humana Inc. is committed to putting health first – for our teammates, our customers and our company through insurance and healthcare services.
Owns end to end operations and expansions for our provider networks in the US & Canada.
Deeply understand and elevate Carrot’s strategic positioning within the US & Canada healthcare and provider ecosystems.
Define and deliver on KPIs related to provider network operations response including establishing goals, methodology on measurement/tracking, and execution.
Carrot is a global, comprehensive fertility and family care platform, supporting members and their families through life's memorable moments. They are trusted by multinational employers and health plans, offering localized support in over 170 countries and 25 languages.
Supports & manages the implementation of market entry plans including vendor and health plan operational alignment.
Validates operational requirements, confirms operational readiness and monitors compliance with contract requirements.
Identifies and develops plans and SOPs for common workflows and resolves operational issues.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Engaging with prospective practices to secure commitment to value-based care contracts.
Extending and negotiating participation agreements using Salesforce CRM/Conga/DocuSign.
Serving as a mentor to Network Development Leads and other Growth / Field team members.
Aledade empowers independent primary care, forming the largest network in the US. They focus on value-based contracts and aim to improve healthcare for patients and practices, with a collaborative and remote-first culture.
Oversee operational and clinical performance of contracted provider partners.
Drive execution on economic, clinical, and population health strategies.
Proactively analyze population health data to identify opportunities for improvement.
Apree Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. They seem to have a fast-paced evolving environment.
-Lead the recruitment of new sites and logos to join the N-Power Network. -Collaborate on refining the value proposition of the N-Power Platform to prospective Network sites. -Develop strategic partnerships with organizations that connect with prospective customers in the community cancer center ecosystem.
N-Power Medicine aims to establish a new paradigm in drug development by reinventing the ‘how’ and transforming clinical trials.
Lead and scale strategic relationships with key partners while driving operational excellence. Build executive-level relationships and represent partner needs internally. Design, implement, and improve processes, influencing senior stakeholders to drive outcomes.
Rula is a remote-first company that believes that mental health is just as important as physical health and aims to create a world where mental health is embraced.
Lead a team of Credentialing Specialists and Operational Analysts to ensure efficient credentialing file processing. Provide coaching and training to strengthen credentialing knowledge and regulatory understanding. Monitor contractual Service Level Agreements, turnaround times, and quality metrics; drive corrective actions to maintain compliance.
Certify is on a mission to change how the US healthcare industry deals with provider data, aiming to reduce healthcare costs by streamlining access to this data.
Lead and optimize the organization’s operational processes, focusing on efficiency, quality, and compliance.
Oversee clinical forms processing, implement workflow improvements, and ensure timely and accurate delivery of services.
Mentor and develop your team, establish performance standards, and collaborate with senior leadership to execute operational strategies.
This position is posted by Jobgether on behalf of a partner company; they use an AI-powered matching process to ensure your application is reviewed quickly and fairly.