Managed Care Provider Relations Manager develops, manages, and sustains relationship with members of physician network of managed care service providers. Recruits new physicians and manages the credentialing and orientation process. Being a Managed Care Provider Relations Manager serves as a resource for physicians, answering questions and providing information about network procedures or contracts. Monitors provider performance and resolves any issues. Additionally, Managed Care Provider Relations Manager reviews billings and claims payments according to managed care contracts. Requires a bachelor's degree. Typically reports to the head of a unit/department. The Managed Care Provider Relations 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 Managed Care Provider Relations 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)
Network and Provider Relations Manager
CommuniCare Advantage, a member of CommuniCare Health Services, is currently recruiting a Network and Provider Relations Manager to support our Medicare Advantage plan in the state of Indiana.
PURPOSE/BELIEF STATEMENT
The Network and Provider Relations Manager is responsible for the execution of a strategic plan to recruit, service and support network providers in an assigned geographic area.
BENEFITS
As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.
QUALIFICATIONS AND EXPERIENCE REQUIREMENTS
KNOWLEDGE/SKILLS/ABILITIES
JOB DUTIES AND RESPONSIBILITIES
About Us
A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients and family members care for and about one another.