2 behavior support specialist jobs found

This position can be located anywhere in the USA Summary This role delivers professional activities in the Provider Contracting job family. The position is responsible for dental provider recruitment and contracting as well as managing contracted provider relationships for a specified territory. Conducts daily outreach to dental offices or providers to develop and maintain positive relationships with the purpose of negotiating a contract for participation in our dental networks. Ability and willingness to travel frequently within the US including overnight stays. Conduct quality reviews of Practitioner and/or Facility/Ancillary contracts. Conducts comparison of contract data relative to provider data and/or demographic and reimbursement data submitted for processing. Assesses the accuracy of provider data processed in accordance with documented and standard operating policies and procedures. Applies standard techniques and procedures to routine instructions that require...

WORK LOCATION: position supports our Glendale, CA market. Must live in the Glendale/Los Angeles, CA area. The Manager, Provider Contracting Network Management serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting. This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory. DUTIES AND RESPONSIBILITIES Manages complex contracting and negotiations for fee for service and value-based reimbursements with healthcare providers (e.g., Hospital systems, Ancillaries, physician groups and individual practices). Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing,...