Managed Care Provider Relations Manager jobs in Indiana

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)

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Network and Provider Relations Manager
  • CommuniCare Family of Companies
  • Indianapolis, IN FULL_TIME
  • 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

    • Bachelor's degree and a minimum 5 years of experience working in network management and/or provider relations.
    • Must have a working knowledge of Medicare programs.
    • Must possess solid knowledge and understanding of managed care industry; and local market conditions.
    • Proficiency in MS Office Suite
    • Must possess valid driver's license.
    • Must be willing to travel within the service area at least 50% of the time

    KNOWLEDGE/SKILLS/ABILITIES

    • Must have integrity and a strong ethical compass.
    • Must be flexible, able to work independently, and able to achieve deadlines and deliverables with minimal supervision.
    • Must have strong communication skills and ability to work effectively with people coming from diverse cultural and professional perspectives.

    JOB DUTIES AND RESPONSIBILITIES

    • Develop the provider network through contract negotiations, relationship development, and servicing all provider types.
    • Develop and maintain positive provider relationships with provider community by regular on-site visits (may be virtual or in person as needed), communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues.
    • Serve as a knowledge and resource expert regarding the most complex provider issues impacting provider satisfaction, research and resolve the most complex provider issues for prompt resolution.
    • Provide assistance regarding education, contract questions and non-routine claim issues.

    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.

  • 1 Day Ago

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Provider Relations Project Coordinator - Remote
  • McLaren Health Care
  • Indianapolis, IN FULL_TIME
  • We are looking for a Provider Relations Project Coordinator to join us in leading our organization forward.McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an orga...
  • 16 Days Ago

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Client Relations Manager
  • Guardian Angels Collaborative Care, LLC
  • Indianapolis, IN PART_TIME
  • Job Summary: This position is to develop and maintain positive relationships with clients by ensuring needs are being met via employees and agency. Additionally, this position is to increase client re...
  • 6 Days Ago

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Marketing/Community Relations Manager
  • Morning Star Hospice and Palliative Care Solutions
  • Warsaw, IN FULL_TIME
  • **JOIN A TEAM THAT MAKES EVERY MOMENT MATTER!!** Morning Star Hospice and Palliative Care Solutions is expanding its reach in the area. We currently service Northeastern Indiana, including Elkhart, Ko...
  • 1 Month Ago

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Managed Care Specialist
  • Brickyard Healthcare
  • Indianapolis, IN FULL_TIME
  • We rely on and trust our Managed Care Specialist (RN or LPN) to provide centralized or field based case management for managed care and commercial insurance payers and residents. The right candidate f...
  • 6 Days Ago

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Managed Care Specialist
  • Anveta, Inc
  • Nashville, IN CONTRACTOR
  • Role: Managed Care Specialist Location: Tennessee Duration: 6 MonthsJob DescriptionKey Responsibilities Determine individual and family eligibility for our Client’s care programs. Assist in coordinati...
  • 11 Days Ago

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Relationship Manager
  • Ascensus
  • Greensboro, NC
  • Newport, an Ascensus company, helps employers offer their associates a more secure financial future through retirement p...
  • 6/11/2024 12:00:00 AM

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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

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Relationship Manager
  • Wilson Hand LLC
  • Salt Lake City, UT
  • At Wilson Hand LLC, our strength is in how we efficiently deliver leading-edge tax products and support to our clients, ...
  • 6/10/2024 12:00:00 AM

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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

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Relationship Manager
  • Flourish
  • New York, NY
  • Flourish was founded in 2017 with the goal of helping financial advisors to better secure the financial futures of their...
  • 6/9/2024 12:00:00 AM

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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

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Relationship Manager
  • AFC Automotive Finance Corporation
  • Austin, TX
  • Who We Are: At AFC (Automotive Finance Corporation) we fuel the entrepreneurial dream in our community. For more than 35...
  • 6/8/2024 12:00:00 AM

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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

Indiana /ˌɪndiˈænə/ (listen) is a U.S. state located in the Midwestern and Great Lakes regions of North America. Indiana is the 38th largest by area and the 17th most populous of the 50 United States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th U.S. state on December 11, 1816. Indiana borders Lake Michigan to the northwest, Michigan to the north, Ohio to the east, Kentucky to the south and southeast, and Illinois to the west. Before becoming a territory, various indigenous peoples and Native Americans inhabited Indiana for thousands of ye...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$98,311 to $141,817

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