Managed Care Provider Relations Manager jobs in Louisiana
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)
Recently Added Managed Care Provider Relations Manager jobs
Medicaid Program Manager 1--B (Managed Care Contracts Manager)
- State of Louisiana
-
Baton Rouge, LA
OTHER
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The Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.LDH serves as a model employer for individuals with disabilities.
This position is located within the Louisiana Department of Health / Medical Vendor Administration / Program Operations and Compliance / East Baton Rouge Parish
Announcement Number: MVA/SP/195668
Cost Center: 3052020600
Position Number: 50465964
This vacancy is being announced as a Classified position and may be filled as a Probationary appointment, Promotional appointment or Detail to Special Duty.
No Civil Service test score is required in order to be considered for this vacancy.
To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
*Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*
A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit
For further information about this vacancy contact:
Shambrielle Pooler
Shambrielle.Pooler@la.gov
LDH/HUMAN RESOURCES
BATON ROUGE, LA 70821
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.MINIMUM QUALIFICATIONS:A baccalaureate degree plus four years of professional experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.SUBSTITUTIONS:
Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.
Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:
A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.
30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.
60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.
90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.
120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.
College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience tosubstitute for the baccalaureate degree.Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; public relations; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.A master's degree in the above fields will substitute for one year of the required experience.A Juris Doctorate will substitute for one year of the required experience.Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required experience.A Ph.D. in the above fields will substitute for two years of the required experience.Advanced degrees will substitute for a maximum of two years of the required experience.NOTE:
Any college hours or degree must be from an accredited college or university.
Function of Work:
To administer small and less complex statewide Medicaid program(s).
Level of Work:
Manager.
Supervision Received:
Broad from a higher-level manager/administrator.
Supervision Exercised:
Supervision over lower-level position(s) in accordance with the Civil Service Allocation Criteria Memo.
Location of Work:
Department of Health and Hospitals.
Job Distinctions:
Differs from Medicaid Program Monitor by responsibility for administering small and less complex statewide program(s) and supervision exercised.
Differs from Medicaid Program Manager 1-A by the presence of supervisory responsibility.
Differs from Medicaid Program Manager 2 by the absence of responsibility for administering medium size or moderately complex statewide program(s) and supervision exercised.Supervises the auditing of eligibility enrollment of all Medicaid programs statewide.
Reviews work of eligibility review staff for quality assurance.
Plans, coordinates, and controls a small or less complex statewide program.
Plans, develops, implements and monitors comprehensive Medicaid program policies.
Conducts and directs studies/special projects pertaining to the programs assigned.
Analyzes the impact of federal, state, and local legislation; advises agency officials; prepares position statements; presents testimony at hearings; writes legislation.
Reviews and analyzes complex data and system reports to ensure compliance with program regulations.
Administers the day-to-day operational functions of the Medicaid fee for service programs. Assures that program policy and procedures are properly applies in accordance with federal and state laws and regulations.
Develops and writes agency rules and regulations governing the administration of all supervised Medicaid programs and submit them for publishing in the official state publication in accordance with the requirements of the Administrative Procedures Act.
Implements Medicaid regulations directing provider participation standards and recipient benefits. Analyzes multi-mullion dollar Medicaid claim data and project the fiscal impact for budget forecasting.
Identifies, verifies and analyzes the various revenue sources for the program(s). Determines and/or confirms match requirements. Monitors availability of revenue sources and promptly identifies existing or potential financing problems. - 2 Days Ago
Director, Provider Relations and Communication
- Louisiana Health Service & Indemnity Company
-
Baton Rouge, LA
FULL_TIME
- We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to appl...
- Just Posted
Director, Provider Relations and Communication
- Blue Cross Blue Shield of Louisiana
-
Baton Rouge, LA
FULL_TIME
- We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to appl...
- Just Posted
Provider - Urgent Care
- The Urgent Care
-
Metairie, LA
FULL_TIME
- General Position Description: To provide patients with outstanding patient care by applying best practices and quality service to aid in the health and well-being of our patients, while also standing ...
- 18 Days Ago
Provider - Urgent Care
- The Urgent Care
-
Laplace, LA
FULL_TIME
- General Position Description: To provide patients with outstanding patient care by applying best practices and quality service to aid in the health and well-being of our patients, while also standing ...
- 24 Days Ago
Provider - Urgent Care
- The Urgent Care
-
Harvey, LA
FULL_TIME
- General Position Description: To provide patients with outstanding patient care by applying best practices and quality service to aid in the health and well-being of our patients, while also standing ...
- 2 Months Ago
Managed Care Provider Relations Manager jobs at Popular Companies
Relationship Manager
- East West Bancorp, Inc.
-
Houston, TX
- As an East West Bank employee, you will be part of a growing and stable organization that provides career path developme...
- 6/12/2024 12:00:00 AM
Relationship Manager
- The Alliance Corporate Office
-
Durham, NC
- Job Description Job Description We are looking for an outgoing relationship manager to foster strong relationships with ...
- 6/12/2024 12:00:00 AM
Relationship Manager
- Palmetto
-
- Company Description Recognized by Forbes as one of the fastest-growing private companies in the United States, Palmetto ...
- 6/12/2024 12:00:00 AM
Relationship Manager
- Allium Financial Advisors, LLC
-
Lake Oswego, OR
- Summary This position is responsible for partnering with Financial Advisors to help manage client relationships by perfo...
- 6/10/2024 12:00:00 AM
Relationship Manager
- Wind River Payments
-
Madison, WI
- As a Relationship Manager at Wind River Payments (WRP), you will thrive on building strong, long-term client relationshi...
- 6/9/2024 12:00:00 AM
Relationship Manager
- Docufree Corporation
-
Millville, NJ
- Job Description Job Description The Relationship Manager is a critical role in the delivery of services to clients and e...
- 6/9/2024 12:00:00 AM
Relationship Manager
- High Flows Capital
-
- Company Description We suggest you enter details here. Role Description This is a full-time on-site role for a Relations...
- 6/8/2024 12:00:00 AM
Relationship Manager
- ComForCare
-
Monroe, NC
- At ComForCare Home Care, we value our employees like family. We celebrate success and have fun. Our focus is to help our...
- 6/8/2024 12:00:00 AM
About Louisiana
Louisiana is bordered to the west by Texas; to the north by Arkansas; to the east by Mississippi; and to the south by the Gulf of Mexico.
The state may properly be divided into two parts, the uplands of the north, and the alluvial along the coast.
The alluvial region includes low swamp lands, coastal marshlands and beaches, and barrier islands that cover about 20,000 square miles (52,000 km2). This area lies principally along the Gulf of Mexico and the Mississippi River, which traverses the state from north to south for a distance of about 600 mi (970 km)) and empties into the Gulf of Mexico; ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$96,386 to $139,039
Most Popular Cities in Louisiana for Managed Care Provider Relations Manager Jobs
What does a Managed Care Provider Relations Manager do?
Managed Care Provider Relations Manager in Trenton, NJ
Rizk says McKesson has created a collegial relationship by reaching out to providers.
January 03, 2020
Managed Care Provider Relations Manager in Gary, IN
Aetna (57% favorable/37% unfavorable) has turned around providers by changing leadership and addressing provider concerns.
February 24, 2020
Managed Care Provider Relations Manager in Birmingham, AL
Providers "want legitimate, honest P4P programs, data exchange, streamlined business processes, and clarity.
November 28, 2019