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)
First MCO, a NJ licensed managed care organization, offers medical case management services to numerous Auto and Workers’ Compensation carriers. A position is currently available for a Per Diem Field Case Manager. Candidate must have excellent computer and time management skills for this work from home position. Exceptional verbal and written communication skills are also needed to interact with claimants, insurance professionals, and health care providers. Previous case management/UR experience is a plus. RN license and valid Driver’s License is required. Great opportunity for professional development. No rotating shifts, weekends or holidays.
First Managed Care Option, Inc., is an Equal Opportunity Employer and takes pride in maintaining a diverse environment. We do not discriminate in recruitment, hiring, training, promotion, or any other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, marital or veteran status, disability, or any other legally protected status.